Factors related to the perceived stigmatization of people living with HIV

A pre-post quasi-experimental study: effect of an educational intervention on the quality of life, and coping strategies of people living with HIV (PLHIV)

INTRODUCTION

The current study provides people living with human immunodeficiency virus (PLHIV) the support to cope with this disease and to improve their quality of life, since their longevity has significantly increased.

AIM

Investigating the effect of an educational intervention on PLHIV's strategies to cope with HIV.

METHODOLOGY

Quasi-experimental, before-and-after study type, whose data were collected before and after educational intervention, was carried out with 75 PLHIV at a School Outpatient Clinic. The Brazilian version of the Ways of Coping Scale was herein used. It is a questionnaire comprising 4 disease-coping domains, namely: coping focused on problem, emotion and on seeking social support and religious practices.

RESULTS

There was increased use of all coping-strategy domains after the educational intervention, as well as reduced standard deviation, and it pointed out that the recorded values were grouped closer to the mean therefore showing less variability. Coping focused on social support was the strategy mostly used after the educational intervention; it was followed by strategies focused on both emotion and problem. The least used strategy was the one focused on religion/fantasy.

DISCUSSION

This study identified the need of introducing a new coping strategy focused on prejudice against patients with HIV.

Concept analysis of shame in nursing

Nurses can facilitate opportunities for patients who feel shame to experience healing in their mental health. Disciplines such as psychology have extensive shame research, yet nursing may provide a unique perspective to bolster research on shame. The objective of this analysis is to examine the use of shame as a concept in nursing literature. This review was guided by Beth Rodgers' Evolutionary approach to concept analysis. Rodgers' approach entails investigating attributes, related terms, surrogate terms, antecedents, and consequences of shame; and examining the use of the concept shame over time to determine if its use changed. Sampled literature came from Cumulative Index to Nursing and Allied Health Literature Plus with Full Text, PubMed, Web of Science, and Health Source: Nursing/Academic Edition. The final sample used for analysis included 334 sources published between 1993 and 2020. The use of shame did not change during these years. Attributes were negative sense of self, feeling worthless, and feeling vulnerable. There were no surrogate terms and three related terms: guilt, humiliation, and embarrassment. Antecedents were trauma, stigma, and perception of moral wrongdoing. Consequences included healthcare avoidance, social withdrawal or isolation, negative coping mechanisms, resilience, lifestyle changes, and healthy coping. There is a discrepancy between the conceptualization and use of shame in nursing and other disciplines. Other disciplines, such as psychology, provide more direction about how interpersonal interactions can elicit or alleviate feelings of shame. Nurses can apply this conceptualization in their clinical practice to support patients experiencing shame.

Psychometric Properties of the Berger HIV Stigma Scale: A Systematic Review

Addressing HIV-related stigma requires the use of psychometrically sound measures. However, despite the Berger HIV stigma scale (HSS) being among the most widely used measures for assessing HIV-related stigma, no study has systematically summarised its psychometric properties. This review investigated the psychometric properties of the HSS. A systematic review of articles published between 2001 and August 2021 was undertaken (CRD42020220305) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additionally, we searched the grey literature and screened the reference lists of the included studies. Of the total 1241 studies that were screened, 166 were included in the review, of which 24 were development and/or validation studies. The rest were observational or experimental studies. All the studies except two reported some aspect of the scale's reliability. The reported internal consistency ranged from acceptable to excellent (Cronbach's alpha ≥ 0.70) in 93.2% of the studies. Only eight studies reported test-retest reliability, and the reported reliability was adequate, except for one study. Only 36 studies assessed and established the HSS's validity. The HSS appears to be a reliable and valid measure of HIV-related stigma. However, the validity evidence came from only 36 studies, most of which were conducted in North America and Europe. Consequently, more validation work is necessary for more precise insights.

HIV-related perceived stigma and associated factors among patients with HIV, Dilla, Ethiopia: A cross-sectional study

Introduction

Understanding HIV-related perceived stigma has importance in improving the quality of patients and provides a better tackling of HIV stigma. Therefore; the study aimed to assess the prevalence and associated factors of perceived stigma among Patients with HIV attending the clinic at Dilla University Referral Hospital in Ethiopia 2019.

Method

In this Institution based cross-sectional study, a 10-item perceived HIV stigma scale was used to assess HIV-related perceived stigma. Oslo social support scale was used to assess social support related factors. Bivariate and multivariate binary logistic analysis was done to identify associated factors to HIV-related perceived stigma.

Results

The prevalence of HIV-related perceived stigma by using perceived HIV stigma scale among patients with living HIV was 42.7%. Patients who are age groups 25-30 years (AOR = 2.8, 95% CI: 5.72-11.5), age groups 31-39 years (AOR = 1.11, 95% CI: 1.26,4.65), Females (AOR = 2.4, 95% CI: 1.28-4.33), divorced marital status (AOR = 8.9, 95% CI: 3.52-10.61), widowed marital status (AOR = 3.0, 95% CI: 2.74-7.60), Primary educational status (AOR = 7.5,95% CI: 3.45-9.74) and Study participants those who use alcohol (AOR = 1.0 95% CI: 1.57-2.11) were more likely to have HIV-related perceived stigma.

Conclusion

This calls a holistic approach to the prevention and intervention of HIV-related perceived stigma. Emphasis should also be given for HIV-related perceived stigma.

Registration

This study was registered research registry with the registration number (researchregistry7112).

Neurocognitive Disorder and Emotional Symptoms in HIV+ Brazilian Elderly: Influence of Gender, Income, Diet, and Sleep

The purpose of this study was to identify factors associated with HIV-associated neurocognitive disorder (HAND) and symptoms of anxiety and depression in HIV+ Brazilian elderly on antiretroviral treatments. The study included 112 HIV+ elderly who completed a questionnaire, tests for cognitive screening, attention, problem solving, processing speed, visual perception, memory, and anxiety and depression scales. The results showed presence of HAND (89.3%), pathological anxiety (48.2%) and depression (58%) in the sample. Higher income was a protective factor for HAND (OR = 0.33). Waking up well-rested (OR = 0.63) and better diet quality (OR = 0.62) reduced the chance of pathological anxiety. Higher education (OR = 0.74) and waking up well-rested (OR = 0.61) reduced the chance of depression. Being female (OR = 7.73) increased the chance of depression. It can be concluded that it is important to evaluate cognitive and emotional aspects of HIV+ elders and to consider social and educational status, diet, and sleep in interventions, paying special attention to elderly women.

Construction and validation of conceptual and operational definitions of the defining characteristics of the nursing diagnosis "Ineffective health self-management" in people living with HIV/AIDS

PURPOSE

Build and validate the content of conceptual and operational definitions of the defining characteristics of the nursing diagnosis of NANDA-I "Ineffective health self-management" in people living with HIV/AIDS.

METHODS

Methodological study, with a quantitative approach. The validation was performed by 26 specialist nurses selected through the Lattes do Brazil platform. The process followed two steps: (a) proposal of new defining characteristics to the Nursing Diagnosis "Ineffective Health Self-Management" and elaboration of conceptual and operational definitions; (b) content validation of the new defining characteristics of the Nursing Diagnosis "Ineffective Health Self-Management" and the conceptual and operational definitions. Data were collected between October 2020 and May 2021.

FINDINGS

The researchers included six defining characteristics as components of the diagnosis, adding to the 10 already existing in the NANDA-I version (2021-2023). Then, the experts judged these components and 13 defining characteristics were validated using the binominal test with adequacy ratio above 85% and p value <0.05. After this stage, the conceptual and operational definitions of these defining characteristics were constructed, validating them by the content validation index ≥0.80 by the expert nurses.

CONCLUSIONS

Three new defining characteristics for Ineffective health self-management were proposed and validated by specialists. Conceptual and operational definitions of the new and current defining characteristics were elaborated and validated for people living with HIV/AIDS.

IMPLICATIONS FOR NURSING PRACTICE

The knowledge and study of the conceptual and operational definitions of nursing diagnoses can contribute to good nursing practices, assisting in the care and evaluation of nurses in the provision of care to people living with HIV/AIDS, and can avoid misunderstandings and inappropriate interpretations and can guarantee assertive clinical judgment.

SEARCH TERMS

Nursing diagnosis, validation studies, nursing processes, acquired immunodeficiency syndrome.

Organization and planning for the creation of the HIV testing and counselling center

OBJECTIVES

To analyze the process of creating the HIV Testing and Counselling Center in the municipality of Nova Iguaçu, in the state of Rio de Janeiro.

METHODS

qualitative research, with a historical approach. The direct sources consisted of written documents and 11 oral testimonies.

RESULTS

in order to create this Testing and Counselling Center, investment was made in the implementation of a Municipal Management Unit for the STD/AIDS Program; in the elaboration of the Project for the Creation of the Testing and Counselling Center; in the process of attracting, selecting and training human resources; and choosing the right place for its operation.

FINAL CONSIDERATIONS

the nurse who coordinated this investment had the support of the authorities of that municipality and had an authorized speech on HIV/AIDS in the municipality of Nova Iguaçu; planned each stage of this service and used effective strategies to create the Testing and Counselling Center.

Percepções acerca da qualidade de vida de pessoas vivendo com HIVaArtigo extraído da tese “Desenvolvimento de escala para avaliar a qualidade de vida de pessoas vivendo com HIV: parte 2” apresentada ao Programa de Pós-Graduação em Enfermagem Fundamental da Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, em 2019

Resumo Objetivo compreender o significado de qualidade de vida atribuído pelas pessoas vivendo com HIV. Método estudo de abordagem qualitativa realizado com pessoas vivendo com HIV, nos Serviços de Atendimento Especializado em um município de grande porte no interior de São Paulo. Os dados foram processados pelo software IRaMuTeQ e a análise foi embasada na técnica do Discurso do Sujeito Coletivo. Resultados após a análise das falas emergiram quatro classes principais: Dificuldades enfrentadas no tratamento; Estigma e diminuição da autoestima; Saúde como centro da qualidade de vida e; Viver com expectativas. Conclusão o significado de qualidade de vida foi compreendido pelas pessoas vivendo com HIV por diversos fatores que permeiam a vida, podendo sofrer influências positivas ou negativas. Os aspectos positivos incluíram hábitos de vida saudável, e os aspectos negativos relacionaram-se ao estigma, preconceito e a dificuldade de adesão ao tratamento.

Self-management of persons living with diabetes mellitus type 2: Experiences of diabetes nurse educators

Background

The global pandemic of diabetes mellitus type 2 (DM2) is the direct cause of significant health and economic problems for both governments and individuals owing to the high level of morbidity and mortality. South Africa has the second highest incidence of DM2 in sub-Saharan Africa.

Aim

This article describes the experiences of diabetes nurse educators in relation to self-management of DM2 of persons living with DM2.

Setting

This article involves nurse educators working in diabetes clinics in public and private hospitals in Nelson Mandela Bay Municipality, South Africa.

Methods

A semi-structured interview guide was used to collect data from a focus group interview comprising three participants and two individual interviews. The interviews were recorded with the permission of participants, transcribed and then coded using Tesch’s model of data analysis. Themes were agreed upon with the consensus of the researcher, two supervisors and an independent coder.

Results

Three themes were identified: (1) diabetes nurse educators have clear perceptions about the importance of self-management of DM2 of persons living with DM2, (2) there are factors that affect persons living with DM2 with respect to self-management and (3) there are ways in which professional nurses can assist persons living with DM2 in the self-management of their condition.

Conclusion

This article identified factors that diabetes nurse educators experienced in either assisting or hindering patients in self-management of their DM2. The diabetes nurse educators voiced their views on how professional nurses can provide support to the patients living with DM2.

Men's sexual and reproductive health in the situation of HIV-serodiscordance

OBJECTIVE

to know men's perspective in face of reproduction in the situation of HIV-serodiscordance.

METHOD

qualitative study developed in a university hospital in Southern Brazil. Unstructured in-depth interviews were conducted with 11 men living with HIV and a thematic content analysis was performed.

RESULTS

men expressed not wanting to have children and that this pregnancy was different. They showed concerns related to the vertical transmission of HIV, sexual and reproductive rights and responsibility in the exercise of parenthood. Final considerations: men's perspective is influenced by their role in the family, which is historically and culturally determined, and by the concerns about infection, which are socially determined and entail their understanding of reproductive rights and their participation in care. In services, men's perspective must be considered in the planning and implementation of health care actions by supporting their participation in the exercise of fatherhood.

How Indigenous and non-Indigenous women look at AIDS: convergences and singularities

OBJECTIVE

To analyze the way AIDS is configured in the eyes of Indigenous and non-Indigenous women.

METHOD

A descriptive study implementing a mixed approach, conducted in three indigenous villages and in a surrounding municipality. A semi-structured interview script was used, with identification data and questions related to the disease perception, the way of seeing and feeling AIDS. The corpus was processed by IRaMuTeQ software and analyzed by Descending Hierarchical Classification, Content Analysis and Word Cloud.

RESULTS

A total of 164 Potiguara indigenous women and 386 non-Indigenous women participated. Three classes were formed: "AIDS and its repercussions", "Social aspects, spirituality and attributed feelings" and "Transmission modes". There was a better understanding of the etiology, treatment and AIDS transmission modes among non- Indigenous women, while the content mainly surrounds negative elements such as death, fear, sadness and prejudice among Indigenous women.

CONCLUSION

The knowledge produced in interactions were formed according to the social context and gain its own significance. Such considerations may contribute to the direction of strategic HIV/AIDS control policies focusing on ethnic/cultural specificities.

HIV Stigma and Moral Judgement: Qualitative Exploration of the Experiences of HIV Stigma and Discrimination among Married Men Living with HIV in Yogyakarta

It is well acknowledged that human immunodeficiency virus stigma (HIV stigma) challenges people living with HIV globally. There is a scarcity of information about determinants of HIV stigma and discrimination among married men in the Indonesian context. This study aimed to explore factors that contribute to stigma and discrimination against HIV-positive men married to women in Yogyakarta, Indonesia. Face-to-face in-depth interviews were conducted to collect data from participants using a snowball sampling technique. A framework analysis was used to guide the analysis of the data. HIV stigma framework was also applied in the conceptualisation and the discussion of the findings. The findings indicate that participants experienced external stigma within healthcare facilities, communities and families. This external stigma was expressed in various discriminatory attitudes and behaviours by healthcare professionals and community and family members. Similarly, participants experienced anticipated stigma as a result of HIV stigma and discrimination experienced by other people living with HIV. Individual moral judgement associating HIV status with amoral behaviours and participants' negative self-judgement were determinants of perceived stigma. The current findings indicate the need for training programs about HIV stigma issues for healthcare professionals. There is also a need to disseminate HIV information and to improve HIV stigma knowledge among families and communities.

HIV Related Stigma and Discrimination among People Living with HIV/AIDS in Ernakulam District: A Qualitative Study

Introduction

Human immunodeficiency virus (HIV)-related stigma refers to the negative beliefs, feelings, and attitudes, while discrimination is the unfair and unjust treatment of people living with HIV/acquired immunodeficiency syndrome (PLHA). Their manifestations are context-specific and have varied impacts.

Objectives

(1) To determine the different contexts in which PLHA face stigma and discrimination. (2) To study the impact of stigma and discrimination on the health of the PLHA.

Methodology

A qualitative study was conducted among PLHA at the office of the network for positives. Fourteen key informant interviews were conducted on PLHA and the peer counselors to determine the contexts in which they faced stigma and discrimination. To understand its impact on health, two Focus Group Discussions were carried out separately for male and female PLHA. The data were collected using a semi-structured interview guide and were audio recorded. They were then transcribed, manually coded, thematically analyzed, and triangulated.

Results

The themes that arose showed that stigma and discrimination were context-specific and were experienced in different levels such as an individual, family, community, health-care system, and media. They experienced violence in addition to the loss of shelter and economic support. Stigma and discrimination was found to have a negative impact on the health of the PLHA. It was a major hindrance to health-care utilization resulting in worsening of health conditions and indirectly contributed to the spread of diseases.

Conclusion

PLHA experience different forms of stigma and discrimination which have an adverse impact on their health. Behavior change communication initiatives for the community are required.

Terapia com antirretrovirais: grau de adesão e a percepção dos indivíduos com HIV/Aids

Resumo Objetivo Apreender os aspectos relacionados ao grau de adesão de pessoas vivendo com HIV/aids aos antirretrovirais. Métodos Estudo com abordagem qualitativa desenvolvido em duas unidades de internação de um hospital universitário do interior paulista. A produção dos dados ocorreu no período de outubro de 2017 a abril de 2018 com 40 participantes entrevistados, cujo material produzido foi gravado e posteriormente transcrito. A análise e o processamento dos dados foram realizados com apoio na técnica da Classificação Hierárquica Descendente e base fundamentada no Discurso do Sujeito Coletivo. Resultados Após análise e processamento, obtiveram-se cinco classes de palavras: 1. Questões sócio-econômicas como motivos fundamentais da não adesão aos antirretrovirais; 2. O apoio familiar para o enfrentamento da condição e estímulo para a adesão ao tratamento; 3. Consequências do grau de adesão aos antirretrovirais; 4. Dificuldades de adesão à terapia antirretroviral relacionadas aos efeitos adversos e apresentação medicamentosa; e 5. Possíveis mudanças para melhorar a adesão ao tratamento do HIV. Conclusão As principais dificuldades enfrentadas por pessoas vivendo com HIV/aids hospitalizadas e que estão em adesão irregular são questões sócio-econômicas, apoio familiar e efeitos adversos.