Making sense of HIV/AIDS: Pascal de Duve and the sensitive historian of education1

ABSTRACT

Since the 1990s historians, in general, have increasingly engaged in critical analyses of the emergence and development of what has come to be known as ‘the HIV/AIDS pandemic’. Historians of education have also become interested in the role-played by education in the history of HIV/AIDS. Although the existing educational histories have successfully examined the multiple and far-reaching power structures that helped shape the educational responses to the disease, I will argue that their focus on ideological and geopolitical power structures runs the risk of losing sight of the crucial and often sensorial responses of individuals who have played a part in the educational history of HIV/AIDS. One such individual is the Flemish philosopher Pascal de Duve, who was diagnosed with HIV in 1989. De Duve’s particular approach to the disease clearly illustrate the importance of the senses in how people attributed particular meanings to HIV/AIDS. Knowing that this approach would prove surprising to both his readership and to his wider television audience, de Duve employed sensory experiences and modes of communication (for instance, gesture) to educative ends. I conclude that an intersensorial approach to the past will render historians of education more sensitive to unexpected personal responses towards HIV/AIDS to unexpected personal responses towards HIV/AIDS.     

Supporting HIV/AIDS affected families and children: the case of four Chinese counties

This article focuses on the impact that HIV/AIDS has on children in China and the social support provided to these children. The research finds that the consequences of HIV/AIDS are serious: the entire environment in which children develop is adversely affected by the disease. These negative socio-economic effects are due not only to HIV/AIDS, but also to the social discrimination and exclusion experienced by affected communities and families. Local governments and societies have started to provide support to HIV/AIDS-affected children and work to reduce the social exclusion they suffer. However, many challenges and problems still lie ahead.     

Common Ground: The Development of a Support Group for Survivors of Homicide Loss in a Rural Community

ABSTRACT

Losing a loved one from human-perpetrated violence can lead to a debilitating process of stigma-generated isolation and trauma. Layers of social services are needed to support surviving family members, all secondary victims of homicide. Although urban populations have enriched access to victims-of-crime services, rural-bound populations often do not. This article describes homicide-specific trauma and the development of a community support group for rural-bound persons suffering homicide loss. The support group process offers potential for real help in areas where few trauma-informed options exist. The authors chronicle their journey of group-work practice with underserved persons coping with homicide loss.     

Hardiness,Successful Aging,and HIV: Implications for Social Work

ABSTRACT

With dramatic developments in the treatment of HIV/AIDS, life expectancy is increasing, resulting in more middle-aged and older adults living with this disease. Little is known about the problems, and especially the strengths, of those living and aging with HIV. Hardiness is used in the gerontological literature to describe and explain how people age successfully, despite traumatic life events and chronic diseases. Similarly, the concept of hardiness may be used to guide clinicians, researchers, and clients on how to age successfully with HIV. This article provides a review of hardiness in aging and HIV, and emphasizes its importance in facilitating successful aging with this disease. Conceptual and methodological concerns in studying hardiness and successful aging are addressed. Potential interventions and clinical implications for social work are posited for augmenting qualities of hardiness in people aging with HIV.     

Resilience among older caregivers in rural Namibia: The role of financial status,social support and health

Background: Namibia has one of the highest human immunodeficiency virus (HIV) prevalence rates and one of the highest rates of orphanhood in the world, and older caregivers provide much of the care to Namibians living with HIV and acquired immune deficiency syndrome (AIDS) (UNAIDS, 2014). In this study, the authors explore how financial status, social support, and health were related to the resilience of caregivers caring for people affected by HIV and AIDS in rural northern Namibia, Africa. Method: Data were collected through a structured interview from (N = 147) caregivers from the Zambezi region. Results: Findings from this study show that employment and physical health were significantly associated with increased resilience in older caregivers. Discussion: Our findings point to the need for employment assistance and health services to improve the resilience of caregivers caring for people living with HIV and AIDS. We conclude that there is a need for more vigorous concerted efforts from public and private sector practitioners and policy makers to create more sustained formal employment opportunities and intervention programs aimed at improving the overall health of older HIV caregivers, especially those residing in rural HIV endemic communities in developing countries.     

The Dance

Abstract

“The Dance” is a story of a young social worker's journey in a HIV+ women's support group. It discusses issues of death, HIV, use of self, and theory application. Most specifically, this essay honors the role of individual strength and love within a group setting.     

Addressing the Vision Challenges of Residents at a Retirement Community: Collaborative Research with a Community Partner

ABSTRACT

Staff members at a community retirement village were concerned about the demise of a support group for residents with vision loss, and requested help developing effective services for residents with vision challenges. This study explored past barriers to support group participation, as they were perceived by residents, family members, and employees. The community partner worked collaboratively with the researcher in all phases of the study. Questionnaires were designed to elicit demographic data, diagnosed vision problems, level of adjustment to vision loss, well-being, and motivation for attending institutional programs about vision challenges. Residents responded to standardized vision and depression scales; qualitative questions were posed to all 3 groups concerning motivations for resident participation in program activities. Results indicated that, although many residents had diagnosed vision conditions, they were, in general, coping well with vision loss and did not report depressive symptoms. Participants considered ongoing personal contact and follow-up, a group design that offered the choice of educational presentations and/or process discussions, and individualized assistance with practical challenges to be critical to an effective program. This case study, utilizing a collaborative research process, generated requests for expanded social work services and an increased valuing of the social work role.     

A Different Kind of Holding Environment: A Case Study of Group Work with Pediatric Staff

ABSTRACT

This paper reports a nearly two-year intervention with staff at a major urban pediatric facility. The authors worked as trainers and consultants for two groups–the Emergency Department (ED) and Chronic Care units (CC). Following two days of training about grief and loss, highlighting skill building for work with traumatized and grieving children and parents, the consultants worked to develop teams which could provide a Winnicottian holding environment for staff. The efficacy of this staff training is analyzed and support needs of staff members are identified. Findings include varied willingness to make use of group support. Chronic care participants are more likely to express willingness to engage in on-going support for one another, while ED staff members seem to prefer structured, educational training and episodic support. The holding environment of the processing groups must be adapted to fit the needs of the medical sub-culture.     

I'm Gone When You're Gone: How a Group Can Survive When Its Leader Takes a Leave of Absence

SUMMARY

As the roles and demands on social workers increase in their agencies and their personal lives, there is a greater chance that they will need to take a leave of absence. This is also true for social workers who lead groups. This article presents a process to allow the primary worker to take a leave of absence while the group continues with an interim worker. The author's personal experience of a leave of absence from a HIV+ adolescent support group will be used to illustrate this transfer process. In providing ample time and a thoughtful process of transfer, this leave of absence was successful in maintaining group attendance and participation.     

Children in Need? Listening to Children whose Parent or Carer is HIV Positive

Correspondence to Kay Tisdall, University of Edinburgh School of Social and Political Studies, Adam Ferguson Building, George Square, Edinburgh EH8 9LL, UK. E-mail: K.Tisdall{at}ed.ac.uk Summary International attention is being brought to the global HIV/AIDS epidemic. In contrast, HIV and AIDS risk being forgottenissues for those living in Scotland. Yet in 2002, numbers ofreported infections have begun to rise. Children and young peopleare even more likely to be affected by parental HIV now, asparents live longer and are able to have more children. Verylittle is known in Scotland about affected children and whethercurrent service provision meets their needs. This research projectsought to address certain of these gaps, by gathering quantitativedata from service providers and qualitative data from interviewing28 affected children and young people. The research found adearth in policies and services, and a failure to audit need.HIV education in schools did not acknowledge that pupils mightbe living with parents who had HIV illness. Children and youngpeople tended to be very involved in the health care of theirparent but none of them received direct support from healthworkers. On the whole the children and young people did notenjoy support from statutory social workers but appreciatedthe support and activities provided by workers in the voluntarysector.     

Group Work for People Touched by HIV/AIDS Yesterday and Today

This article recounts the experience of a support group in the early days of the AIDS pandemic. After identifying the personal, interpersonal, and environmental issues that were part of the work of this early support group, the article reflects on how far we have come in addressing people's needs around HIV/AIDS. The importance of group work in working at personal and political levels is highlighted.     

International research: Ethical imperialism or ethical pluralism? 1

Conflicts have arisen in international research when countries in which research is being carried out lack the ethical rules or mechanisms for review employed in the United States and Europe. It is objected that a requirement to adhere to regulations promulgated by the US government constitutes “ethical imperialism.”; But if researchers in some countries need not be bound by ethical standards widely accepted in the conduct of research, it could open the door to an ethical relativism allowing virtually any standard a country desires to accept. One example is the variations in informed consent, especially in countries that accord lesser importance to the individual than do the US and Europe. A recent controversy centered on a series of placebo‐controlled, HIV/AIDS trials sponsored by the United States and conducted in several developing countries. These trials could not ethically be carried out in the United States because a proven effective treatment exists. Attempts to avoid similar controversies in forthcoming HIV/AIDS vaccine trials have been initiated by the joint United Nations AIDS program, with a process of regional consultations in the countries where the research will be conducted.     

Needs and Supports in Transitional Housing for People Living with HIV/AIDS in Ontario,Canada

ABSTRACT

There is a paucity of research on transitional housing for people living with HIV/AIDS (PHA) and even less so within the Canadian context. The present work addresses that gap and reports on the results from the Transitional Housing Study, a province wide community-based research collaboration involving PHA, service providers, and university researchers in Ontario Canada. This article answers the following research questions: What supports do residents in transitional housing for PHA access and what needs do these supports address? Developing from a thematic analysis of in-depth qualitative interviews with 25 residents in one of three transitional housing agencies in Ontario for PHA, the findings reveal that participants benefited from four key supports while in transitional housing: the provision of a safe environment, co-coordination and management of HIV (and other) drug therapies, assistance with appointments, and referrals to health and social services. Until more resources are available to increase availability of transitional housing for PHA, the nonprofit housing sector must fill the gap that exists by offering the types of supports identified in this study in order to address the needs of PHA. Future research may link these supports efficiently with concrete health improvements and permanent housing stability among PHA.     

Experiences of Stigma and Spirituality of Older Black Men Living with HIV

Abstract

Previous research on HIV stigma and the use of spirituality by people living with HIV/AIDS is scarce. Moreover, the research with older Black men who have sex with men is scant. This study aimed to investigate experiences of HIV stigma and the use of spirituality among older HIV positive Black men who sleep with men. In-depth interviews were conducted with a sample of ten men. Data were analyzed utilizing to the modified van Kaam data analysis method. Three major themes were identified that explores the participants lived experiences with HIV stigma and use of spirituality: experiences of stigma reinforcing the use of spirituality; defining spirituality as a functional concept; and self-empowerment through the use of spirituality. The findings could guide social workers and other helping professionals in developing informed assessments and interventions regarding HIV stigma and the use of spirituality. Future qualitative and quantitative research is needed to achieve generalizable knowledge about the relationship between stigma on the use of spirituality.     

HIV/AIDS treatments

Although fewer people are being diagnosed with AIDS in the U.S. and deaths continue to decline, the number of adults age 50 and older who are living with HIV/AIDS is larger than ever. It is likely that older people will continue to comprise an increasingly larger proportion of individuals diagnosed with HIV/AIDS, reflecting both the ineffective prevention efforts targeting older adults and the highly effective antiretroviral therapies that allow many people to live for significantly longer periods of time. These recent trends have created two distinct populations of older persons with HIV/AIDS: those who were infected later in life and those infected earlier and now aging with HIV disease. Aging with HIV/AIDS presents unique psychosocial challenges that may be exacerbated by the aging process. HIV-related stigma, social support and coping issues and evidence-based psychosocial interventions for older adults with HIV/AIDS are reviewed in this paper and suggestions for future research are discussed.     

BOOK REVIEWS

Abstract

MOVING BEYOND THE COMFORT ZONE IN PSYCHOTHERAPY. Nancy A. Bridges. Lanham, MD: Jason Aronson, 2005, 196pp. Reviewed by Julie Mencher.

PRACTICE ISSUES IN HIV/AIDS SERVICES: EMPOWERMENT-BASED MODELS AND PROGRAM APPLICATIONS. Ronald J.Mancoske and James Donald Smith (Eds). Binghamton, NY: The Haworth Press, Inc., 2004, 224 pp. Reviewed by Darrell P. Wheeler.     

Hepatitis C psychoeducation curriculum topics generated by group members

ABSTRACT

Educational programs for hepatitis C (HCV) have been created by professionals. There has not been a focus on whether what clients want to know about HCV differs from what providers want patients to know. This study addresses this gap by examining topics selected by participants in an education/support group model. Data were collected as part of a randomized psychoeducation trial for patients with HCV. Topics were systematically generated by the members uniquely for each group. Topics and rank order for each group were generated and a combined variable was created. Twenty-eight different topics were identified across 12 groups. The total number of topics was 102, averaging 8.5 per group. Topics are divided into three separate conceptual groups, members’ personal relationship to HCV, medical aspects of HCV, and unique concerns. A patient-centered approach that addresses the needs of HCV patients first provides an optimal starting point to discuss HCV disease management.     

Single-Session Groups: Issues for Social Workers

ABSRACT

Single-session groups in hospital settings provide a lifeline to overwhelmed patients and family members. Although these groups are becoming more common, they present special issues for the social worker committed to making them as useful as possible to participants. This paper highlights four major issues: handling ongoing recruitment, allowing sufficient time for the beginning phase, setting realistic goals, and dealing with heterogeneous group membership. Illustrative examples are based on the author's experience with single-session groups for family members of liver transplant patients. Learning more about the special nature of single-session groups will help workers prepare for them and also capitalize on the unique opportunities they offer.