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Article
Publication date: 15 June 2015

Mervyn Turton and Sudeshni Naidoo

The purpose of this paper is to ascertain the oral health experiences of people living with HIV/AIDS in the provinces of Kwazulu-Natal (KZN) and Western Cape (WC) in South Africa…

Abstract

Purpose

The purpose of this paper is to ascertain the oral health experiences of people living with HIV/AIDS in the provinces of Kwazulu-Natal (KZN) and Western Cape (WC) in South Africa. Many studies have reported that people living with HIV have unmet needs for dental care and this study considered the various factors that affect the accessibility and utilisation of dental services as these factors are even more pertinent for the people living with HIV who have increased need for dental care.

Design/methodology/approach

The participants were selected among HIV-positive people attending selected Community Health Centre and regional hospital HIV clinics in KZN and WC provinces. The sample consisted of people living with HIV that were 18 years or older and who had given written, informed consent. The sample (n=435) comprised mainly of black females in the age group 20-29 years. In total, 347 participants (79.8 per cent) had an oral health problem of which 83 per cent (n=288) received care.

Findings

Of those that received care, 56.6 per cent (n=163) of the participants stated that the staff were aware of their HIV status. Almost a third of the participants who received care reported a negative experience at the clinic. If the participant lived in a metropolitan area, the participant was 3.647 times more likely to receive care than if the participant lived in a non-metropolitan area (p < 0.01) If the participant earned R5,000 or less, the participant was 0.106 times less likely to receive care (p=0.048). If the participant lived 1-5 km from the clinic, the participant was 3.371 times more likely to receive care (p=0.015).

Research limitations/implications

The results are specific to KZN and WC and cannot be extrapolated with caution to the rest of South Africa. However, to the best of the author’s knowledge, there is no other study that has compared differences in the use of oral health care services by people with HIV in South Africa and these results serve as an indication of some the important issues in this regard. Additionally, this study did not have a control group of HIV-negative people which would have enabled one to determine whether certain barriers were unique to people living with HIV.

Practical implications

The study highlighted the barriers to care existing within the current public health system relative to the provision of oral health services for people living with HIV in KZN and WC. It was anticipated that by ascertaining the nature and extent of unmet needs and barriers to dental care for people living with HIV, measures can be put in place to remove or at least reduce the barriers to care and improve the quality of life for people living with HIV/AIDS in South African communities.

Social implications

The high prevalence of oral health problems in people living with HIV makes it imperative for the DOH to make every attempt to remove barriers to oral health care and thereby secure equitable, affordable and accessible oral health care which is acceptable for people living with HIV and accountable to the greater society.

Originality/value

This study emphasises the importance of embracing people that are being discriminated and marginalised by society such as people living with HIV to ensure that they feel a franchised member of society who can take the initiative to be in control of their own health and, with the necessary aid from public resources and societal support, join forces to reduce the public health burden and its impact on the socio-economic milieu.

Details

International Journal of Human Rights in Healthcare, vol. 8 no. 2
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 4 December 2019

Francis Kwotua Apungu, Charles Apprey, Emmanuel Kobla Atsu Amewu, Samuel Terkper Ahuno and Alexander Kwarteng

The purpose of the study is to assess the nutritional and health status of people living with HIV/AIDS (18-60 years) in selected health facilities in the eastern region of Ghana…

Abstract

Purpose

The purpose of the study is to assess the nutritional and health status of people living with HIV/AIDS (18-60 years) in selected health facilities in the eastern region of Ghana and to determine the influence nutrition support programmes (NSP) have on the nutritional and health status of people living with HIV/AIDS.

Design/methodology/approach

A retrospective study design was used. Purposive and convenience sampling was used to select four hospitals and 200 beneficiaries and non-beneficiaries of the NSP. A structured questionnaire was used to collect the sociodemographic, anthropometric, biochemical and clinical history of the participants. Dietary intake was assessed with food frequency and 24-h dietary intake questionnaires. Previous data from the medical record within three to six months before the research was collected and compared with current data.

Findings

The prevalence of underweight (using body mass index) was 17 per cent and overweight/obesity was 37 per cent. Most respondents had adequate consumption of phosphorus (70.5 per cent); inadequate intake of calcium (95 per cent), vitamin E (77.5 per cent) and vitamin A (94 per cent); and excess intakes of sodium (93 per cent), selenium (77 per cent), copper (83.5 per cent) and manganese (76 per cent). There was no significant difference in nutrient intake of beneficiaries and non-beneficiaries of the NSP, although there were significant differences in the frequency of consumption of fruits (p < 0.001), vegetables (p < 0.001), legumes (p = 0.002), animal foods (p < 0.001) and cereals, grains and starch (p < 0.001) between beneficiaries and non-beneficiaries of NSP. About 38 and 20 per cent of respondents, respectively, had low haemoglobin (Hb < 11 g/dL) and high viral load (1,000 cp/mL). Comparing the current and previous (three to six months before the study) health and nutritional status of beneficiaries and non-beneficiaries of NSP, among the beneficiaries of NSP, monocytes increased by 40.6 per cent (p = 0.028) and mean weight decreased by 2.4 per cent (p = 0.007), Hb decreased by 7.1 per cent (p = 0.27) and viral load decreased by 4.2 per cent (p = 0.49), whereas among the non-beneficiaries, mean weight decreased by 0.05 per cent (p = 0.95) and Hb increased by 9.6 per cent (p = 0.06) and monocytes increased (p = 0.28) and viral load increased by 98.2 per cent (p = 0.34).

Research limitations/implications

A significant proportion of people living with HIV/AIDS had a high prevalence of underweight and overweight/obesity, inadequate nutrients intake and high viral load. The NSP for people living with HIV/AIDS in the eastern region of Ghana did not significantly influence the nutritional and health status of these people.

Practical implications

Knowing the nutritional status will help health institutions plan activities towards improving the health and nutritional status of people living with HIV/AIDS. This research is aimed at not only contributing to the existing body of knowledge but also making recommendations of action towards improving NSPs of people living with HIV/AIDS.

Social implications

Improvement in nutritional and health status of people living with HIV/AIDS will help reduce morbidity and mortality and its related cost to families, communities and the nation.

Originality/value

This study is first to determine the influence of NSPs on nutritional and health status of people living with HIV/AIDS in the eastern region of Ghana.

Details

Nutrition & Food Science , vol. 50 no. 4
Type: Research Article
ISSN: 0034-6659

Keywords

Article
Publication date: 12 March 2014

Mervyn Turton and Sudeshni Naidoo

The purpose of this paper is to determine the oral health care experiences of people living with HIV in Kwazulu-Natal (KZN) and the Western Cape (WC) and also to identify the role…

Abstract

Purpose

The purpose of this paper is to determine the oral health care experiences of people living with HIV in Kwazulu-Natal (KZN) and the Western Cape (WC) and also to identify the role of stigma and discrimination in the oral health care experiences for people living with HIV in KZN and the WC.

Design/methodology/approach

This study was a survey among HIV-positive people attending selected Community Health Centres and regional hospitals, HIV clinics in KZN and WC provinces in South Africa. The sample consisted of people living with HIV that were 18 years or older and who had given written, informed consent. A cross-sectional study structure has been employed using a standardized format using a semi-structured interview and an administered questionnaire to collect data. The study classified participants as living in metropolitan or non-metropolitan areas.

Findings

Apprehension of loss of confidentiality, stigma and discrimination were the barriers that deterred participants from seeking care. Respondents stated that they feared what the dentist and staff would think of them being HIV positive and feared being discriminated against by the dentist and staff. In some instances there appears to be a difference between policy and practice regarding the oral health care needs of and services rendered to people living with HIV in public health facilities as there are still patients who do not obtain care and for whom the attitudes of the health care provider constitutes the major barrier to accessing that care.

Research limitations/implications

The results are specific to KZN and WC and have to be extrapolated with caution to the rest of South Africa. Additionally, this study did not have a control group of HIV-negative people which would have enabled one to determine whether certain barriers were unique to people living with HIV.

Practical implications

To make recommendations with respect to addressing the issue of stigma and discrimination in the oral health care experiences for people living with HIV in KZN and the WC as there is a definite need for the government to address the resource needs of rural areas and less developed areas of South Africa. Health care is a much-needed resource in these high prevalence areas and governments must ensure that all their HIV/AIDS projects and policies should have a rural component built into them.

Social implications

This study emphasizes the importance of embracing people that are being discriminated and marginalized by society such as people living with HIV to ensure that they feel a franchised member of society who can take the initiative to be in control of their own health and, with the necessary aid from public resources and societal support, join forces to reduce the public health burden and its impact on the socio-economic milieu.

Originality/value

To the best of the author's knowledge, there is no other study that has compared differences in the use of oral health care services by people with HIV in South Africa and these results serve as an indication of some the important issues in this regard.

Details

Ethnicity and Inequalities in Health and Social Care, vol. 7 no. 1
Type: Research Article
ISSN: 1757-0980

Keywords

Article
Publication date: 12 September 2016

Añiela dela Cruz, Vera Caine and Judy Mill

Canadian epidemiological data suggest an increasing number of HIV infections among people from HIV-endemic countries, including sub-Saharan Africa. Currently, there are few…

Abstract

Purpose

Canadian epidemiological data suggest an increasing number of HIV infections among people from HIV-endemic countries, including sub-Saharan Africa. Currently, there are few studies that focus on the lived experience of HIV illness among Canadian residents of African ancestry. The purpose of this paper is to study the lived experiences of African immigrants living with HIV in Canada, using narrative inquiry methodology.

Design/methodology/approach

This qualitative study focussed on the experiences of sub-Saharan African immigrants living with HIV in Alberta, Canada. Using the philosophical underpinnings of narrative inquiry methodology (Clandinin, 2013), three African immigrants living with HIV in Alberta contributed to this study over an extended period of time. Between five and six interviews were conducted with each participant, over a period of 12 months. Interviews were digitally recorded, transcribed, and negotiated with each participant during analysis to uncover the experience and meaning of living with HIV as African immigrants in Canada.

Findings

The researchers found several narrative threads related to: stigma, social, and family exclusion; as well as HIV illness as a complex personal, familial, and social experience. Also, narratives across different geographic and social spaces shaped the complex experience among African immigrants living with HIV in their new host country of Canada.

Research limitations/implications

The authors recognize that the sample size, though appropriate for narrative inquiry study, was small. The intention with this research was not to generalize findings to the broader African immigrant community that is affected by HIV illness in Canada. Rather, the intent was to demonstrate a deeper understanding of lived experience, among African immigrants living with HIV in Canada.

Social implications

The findings show the complex personal, familial, and societal factors that shape the experience of living with HIV and HIV-related stigma among African immigrants. It is important to understand such factors and the experience of HIV-related stigma because such experiences impact access to health and social services, as well as health and social outcomes of immigrants living with HIV.

Originality/value

This is the first Canadian study to examine lived experience of African immigrants living with HIV in Canada. This study demonstrates a deep understanding of lived experience, among African immigrants living with HIV in Canada. Complex personal, familial, and societal factors shape the experience of living with HIV and HIV-related stigma. Based on the findings of this study, further research is needed to: study more closely the familial contexts of African families affected by HIV in Canada; explore the social and political landscapes that impact the experience of HIV illness and related stigma in Canada, in the context of migration and settlement; and examine the relationship between these experiences and the health and social outcomes of African immigrants living with HIV in Canada.

Details

International Journal of Migration, Health and Social Care, vol. 12 no. 3
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 12 December 2016

Alan Tai-Wai Li, Josephine Pui-Hing Wong, Roy Cain and Kenneth Po-Lun Fung

Racialized minority and newcomer communities are over-represented in positive HIV cases in Canada. Stigma has been identified as one of the barriers to HIV prevention, testing…

Abstract

Purpose

Racialized minority and newcomer communities are over-represented in positive HIV cases in Canada. Stigma has been identified as one of the barriers to HIV prevention, testing, and treatment. Faith, media, and social justice sectors have historically served a vital role in promoting health issues in these communities. However, they have been relatively inactive in addressing HIV-related issues. The purpose of this paper is to report on the results of an exploratory study that engaged faith, media, and social justice leaders in the African-Caribbean, Asian, and Latino communities in Toronto.

Design/methodology/approach

This study used a qualitative interpretive design and focus groups to explore the challenges and opportunities in addressing HIV stigma. A total of 23 people living with HIV and 22 community leaders took part in seven focus groups. Intersectionality was used as an analytical lens to examine the social processes that perpetuate HIV stigma.

Findings

This paper focuses on the perspectives of community leaders. Five themes were identified: misconception of HIV as a gay disease; moralistic religious discourses perpetuate HIV stigma; invisibility of HIV reinforces community denial; need to promote awareness and compassion for people with HIV; and the power of collective community efforts within and across different sectors.

Originality/value

Although affected communities are faced with many challenges related to HIV stigma, effective change may be possible through concerted efforts championed by people living with HIV and community leaders. One important strategy identified by the participants is to build strategic alliances among the HIV, media, faith, social justice, and other sectors. Such alliances can develop public education and HIV champion activities to promote public awareness and positive emotional connections with HIV issues, challenge HIV stigma and related systems of oppression, and engage young people in HIV championship.

Details

International Journal of Migration, Health and Social Care, vol. 12 no. 4
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 6 April 2011

John R. Cutcliffe and Kirk Zinck

Background: The introduction of antiviral agents, most particularly ‘highly active antiretroviral therapy’ (HAART), has changed the very nature of the care for persons with HIV

Abstract

Background: The introduction of antiviral agents, most particularly ‘highly active antiretroviral therapy’ (HAART), has changed the very nature of the care for persons with HIV and/or AIDS, from preparing patients to die to assisting patients with living with a chronic illness. Despite this dramatic turnaround in prognosis, the limited literature available indicates that these individuals often do not have a high degree of hope for the future. Accordingly, this study seeks to explain how hope might be inspired and maintained in people living long‐term with HIV/AIDS (the so‐called ‘Lazarus Syndrome’). Design: The study used a modified Glaserian grounded theory method and was conducted in the United States of America. A total of 10 participants were selected by means of theoretical sampling. Methods: The study adhered to the principal features of Glaserian Grounded Theory, namely: (a) theory generation, not theory verification; (b) theoretical sampling; (c) the constant comparative method of data analysis; and (d) theoretical sensitivity (searching for/discovering the core variable, one which identifies the key psychosocial process and contains temporal dimensions or stages). Further, the authors ensured that the study was concerned with generating conceptual theory, not conceptual description. Findings/conclusion: The findings indicate that the key psychosocial problem (i.e. the maintenance of hope) is addressed through the core variable, ‘Turning from death to life: finding new meaning’. This parsimonious theory describes and explains a four‐stage process of hope maintenance consisting of the subcore variables: ‘Losing the Ontological Self’, ‘Turning from Death to Life’, ‘Finding Acceptance and Reconciliation’, and ‘Finding New Meaning’.

Details

Qualitative Research Journal, vol. 11 no. 1
Type: Research Article
ISSN: 1443-9883

Keywords

Open Access
Article
Publication date: 24 August 2021

Supalak Phonphithak, Narin Hiransuthikul, Penchan Pradubmook Sherer and Sasithorn Bureechai

This aim of this study was to explore the experiences of stigmatization and coping mechanisms during pregnancy among pregnant women who are living with HIV in Thailand. The…

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Abstract

Purpose

This aim of this study was to explore the experiences of stigmatization and coping mechanisms during pregnancy among pregnant women who are living with HIV in Thailand. The secondary objective was to determine factors contributing to stigma during motherhood among HIV-infected women as well as explore how they cope with the discrimination from society.

Design/methodology/approach

Qualitative data were collected using in-depth interviews to obtain different versions of stigmatized experience from 16 pregnant women living with HIV on stigmatization and coping mechanisms. There were 5 pregnant adolescents living with HIV and 11 adult pregnant women living with HIV. The content analysis was used to examine patterns of stigmatizations and attributed factors.

Findings

Personal stigma was found among pregnant women living with HIV regardless of age. HIV status disclosure was the crucial barrier of accessing to care for people experiencing stigmatizations. Personal stigma associated with higher HIV status was not disclosed. Interestingly, all teenage mothers who participated in this study disclosed their HIV-status to their family. People who have social support especially from family and significant others are found to be able to cope and get through the difficulties better than those who lack those social support.

Originality/value

This study yields outcomes similar to several other studies that have been conducted either in Thailand or other countries. This study found that family support was crucial in reducing HIV stigma. Furthermore, HIV-infected pregnant female adults were more afraid to disclose their HIV status to their husbands, other family members and their work colleagues.

Details

Journal of Health Research, vol. 36 no. 6
Type: Research Article
ISSN: 0857-4421

Keywords

Article
Publication date: 1 December 2008

William N. Ndlela

Swaziland is one of the countries with the highest Human Immune-deficiency Virus (HIV) rates in the world. Consequently, the increased need for care and support for people living

Abstract

Swaziland is one of the countries with the highest Human Immune-deficiency Virus (HIV) rates in the world. Consequently, the increased need for care and support for people living with Acquired Immune-deficiency Syndrome (AIDS), as well as orphaned and vulnerable children, is unprecedented. The response to combat the HIV epidemic has been evident in many areas as the country continues its fight against the HIV epidemic. However, efforts to provide care and support - including Anti-Retroviral Therapy (ART), management of opportunistic infections, and community home-based care - have, so far, largely stemmed from the health sector. Housing care and other non-medical support is continuing to lag behind. Lack of proper housing is one of the deprivations suffered by orphaned children and people living with AIDS, which predisposes them to attacks by opportunistic infections and other vulnerabilities and disrupts the continuum of care, whilst at times denying occupants the required privacy.

This paper focuses on creating an understanding of why housing care and support for HIV and AIDS affected is lagging behind in Swaziland. It suggests cultural, economic, political and policy issues as the underlying reasons for this, and, therefore, concludes that there is need for bold policy reforms in these areas. In order to create a proper framework for such reforms, the paper reviews the following:

1. The national housing policy's implications on the care and support for people living with HIV and AIDS and the orphaned and vulnerable children; and

2. The current human settlements related responses to HIV and AIDS in Swaziland's rural, peri-urban and urban areas.

In this context, urban development planning paradigms and the extent to which HIV and AIDS is being integrated into the development plans are discussed.

Details

Open House International, vol. 33 no. 4
Type: Research Article
ISSN: 0168-2601

Keywords

Book part
Publication date: 21 October 2008

Donna B. Barnes

Women with HIV have increased longevity and the potential for decreasing mother to child transmission with the use of antiretroviral therapy. Since the beginning of the AIDS…

Abstract

Women with HIV have increased longevity and the potential for decreasing mother to child transmission with the use of antiretroviral therapy. Since the beginning of the AIDS epidemic in 1980, the disease has evolved from an acute condition to a chronic one. How have women long-term survivors transitioned from a “death sentence” to living with HIV/AIDS as a chronic illness? In this study, we investigate the reproductive, mothering, and living experiences of HIV positive women 10 years after their participation in a study of their reproductive decisions. The sample was taken from two groups of women living with HIV (n = 60), one in Oakland, California (n = 30) and one in Rochester, New York (n = 30). Both groups participated in the initial study (1995–2001). The inclusion criteria for this study are women with HIV who are living and well enough to participate in a face-to-face interview. Of the original 60 women, 52 women are living. Two and one half years into this 4-year study, the author has completed interviews with 25 women from Oakland (n = 10) and Rochester (n = 15). An unexpected life with HIV challenges participants to live a viable life different from their pre-diagnosed life. It involves a life of defining normalcy in everyday experiences and building a legacy of a life worth living. Participants’ issues and concerns of living with HIV/AIDS identify what kinds of cultural notions, and medical and social interventions support or undermine women's reproductive, mothering, and long-term living with HIV/AIDS.

Details

Care for Major Health Problems and Population Health Concerns: Impacts on Patients, Providers and Policy
Type: Book
ISBN: 978-1-84855-160-2

Article
Publication date: 10 October 2022

Akm Ahsan Ullah and Ahmed Shafiqul Huque

HIV or AIDS remains invisible and dismissed by most South Asians living in Canada as HIV or AIDS issues are perceived as an offshoot of Western lifestyle linked with drug use and…

Abstract

Purpose

HIV or AIDS remains invisible and dismissed by most South Asians living in Canada as HIV or AIDS issues are perceived as an offshoot of Western lifestyle linked with drug use and promiscuity. This paper aims to look into how people living with HIV or AIDS (PLWHA) cope with prejudice and stigma.

Design/methodology/approach

To guide this research, a constructivist grounded theory approach was adopted as the theoretical and methodological framework. The authors reached the participants through a Toronto-based group that works with PLWHA. The authors chose their respondents in a snowball method and interviewed them both in person and online.

Findings

This paper identifies how South Asian immigrants and refugees/refugees with HIV or AIDS claimants are vulnerable to discrimination in Canada due to the following factors, which include but are not limited to: a lack of information about HIV and AIDS incidence in the community; and the Canadian health system's inability to respond appropriately to the lack of information.

Practical implications

HIV service engagements should take place within the context of a constellation of local traditions, or standardized expectations of patient engagement with HIV services can be counterproductive.

Originality/value

It is critical that governmental action prioritizes increasing public understanding of stigma. To minimize the consequences of HIV-related discrimination and stigma, misconceptions about HIV transmission must be debunked.

Details

International Journal of Human Rights in Healthcare, vol. 17 no. 3
Type: Research Article
ISSN: 2056-4902

Keywords

1 – 10 of over 4000