Transferring HIV/AIDS Related Healthcare from Non‐governmental Organizations to the Public Healthcare System in South Africa: Opportunities and Challenges

Almost two decades after the transition to a post‐apartheid regime, South Africa is still high‐ranking in the incidence of chronic diseases like tuberculosis, HIV/AIDS, diabetes and hypertension. This article explores the transition from HIV/AIDS related healthcare offered by internationally supported non‐governmental organizations (NGOs) in rural areas to the inclusion of this healthcare into the public healthcare system. This transition is part of a wider process that represents the exact reverse of healthcare reforms in Western industrialized countries. Instead of a transition from public healthcare to privatized or marketized healthcare, the transition in South Africa is from partly private healthcare to a public healthcare system in which the private commercial health sector as well as all services provided by NGOs will be integrated. In that process, many obstacles obscure intended outcomes, such as equal access to healthcare. Some obstacles are evident in the case studies of two internationally supported NGOs in the field of HIV/AIDS healthcare. We will conclude that governance structures of public and private NGO‐based healthcare are often difficult to integrate; implementation timelines and priorities do not always coincide; and the public healthcare system is still too weak to deliver good quality healthcare in rural areas without continued NGO support.     

Beneath the Mask: A Group Therapy Model Supporting Children Infected With and Affected by HIV/AIDS

In 2007 a study was conducted to identify the outcomes of an activity-based psychosocial intervention called Leading the Way, a program designed for children infected with and/or affected by HIV/AIDS, based in Toronto, Canada. Qualitative and quantitative data showed that children who were unaware of the HIV status of their families experienced heightened anxiety and depression when compared to children who were aware of the presence of HIV in their families. Furthermore, data indicated that though the intervention positively influenced children's senses of self and their ability to cope and problem solve, deep social stigma surrounding HIV continued to profoundly affect the lives of these children. The ethical dilemmas involved in serving populations of children who have not been disclosed to regarding their own or a family members' HIV status came to light in the development of the program and are discussed in the analysis of data.     

Parental attitudes regarding the integration of children living with HIV/AIDS into public schools in Hanoi,Vietnam

In some areas of Vietnam, stigmatisation of HIV-infected children by parents in the community represents a major barrier to integration of such youth into public schools. To investigate parental perceptions of integration, researchers interviewed a total of 60 parents from one rural and one urban school district within Hanoi, Vietnam. Resistance to integration stemmed largely from misinformation about disease transmission and worry about protecting HIV-negative children. Educational campaigns targeted at parents, combined with higher levels of trust in the preparedness of teachers to handle situations involving HIV-positive children, could decrease current stigma and opposition to integration into public primary schools.     

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.     

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.     

Challenges of Depression and Suicidal Ideation Associated With Aging With HIV/AIDS: Implications for Social Work

As the number of older adults with HIV/AIDS increases, new challenges are emerging that threaten their ability to age with this disease. Threats of particular concern are depression and suicidal ideation. Studies show that those aging with HIV/AIDS have a number of stressors that tax their coping mechanisms, increasing vulnerability to depression and suicidal ideation. These stressors can be categorized into three areas. First, there are psychosocial stressors that can contribute to depression. Second, there are health and biochemical stressors that can contribute to depression, as well as compromise cognitive abilities needed to adapt to such stressors. Third, cognitive stressors may create predispositions to depression. In particular, certain cognitive abilities needed to cope with depression and suicidal ideation may be compromised by aging with HIV/AIDS. A model of these stressors is provided for didactic purposes, as well as to suggest implications for social work practice and research.     

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.     

Disability benefits and workers with HIV/AIDS: Coverage issues and challenges in the United Republic of Tanzania

This paper explores the effective non‐availability of disability/invalidity benefits to formal sector employees with HIV/AIDS in the United Republic of Tanzania. The legal difficulty of establishing a direct connection between HIV/AIDS and employment injury and occupational diseases present a challenge to social security institutions and schemes which are simultaneously trying to come to grips with the mounting problems of the shrinkage of the formal sector and low coverage. Remedial policy responses are proposed. These identify the statutory and legal adjustments needed both to ensure convergence of eligibility criteria for invalidity benefit claims among the concerned institutions, and to ensure that qualifying conditions are both consistent and in line with contemporary approaches to disbility. The suggested adjustments would simplify and clarify eligibility criteria in cases of invalidity involving existing scheme members, potentially also allowing for a future expansion of benefit coverage better to reflect labour market realities.     

Ethnic and cultural differences in knowledge about HIV and AIDS: a study of 150 young women from Sweden, Chile and Ecuador

This article illustrates the differences in knowledge about HIV and AIDS and attitudes among 150 young women from three different countries (Sweden, Chile and Ecuador). In each country, 50 consecutive women, visiting a family planning clinic answered 23 structured questions. The questionnaire was translated into Spanish. The aim of this study was to evaluate the influence of age, education, ethnicity and religion on young women's knowledge of HIV and AIDS. This study shows that ethnicity is the most important independent variable influencing the level of knowledge (stepwise logistic regression). Also, in Chile and Ecuador, less than 10% of the women in the study required that their partner use a condom. In Sweden the use of condoms is often combined with another contraceptive, yet more than two thirds of the women in Sweden were unprotected from a sexually transmitted disease during coitus.