Nurse practitioner, nurse midwife and physician assistant attitudes and care practices related to persons with HIV/AIDS

Although multiple studies of nurses' attitudes toward people living with HIV/AIDS (PLWAs) can be found in the literature, little is known about the attitudes, beliefs and practices of nurse practitioners (NPs), certified nurse midwives (CNMs), and physician assistants (PAs). A survey including a 21-item AIDS Attitude Scale measuring the constructs of Avoidance and Empathy was sent to 1,291 NPs, CNMs and PAs in Louisiana, Arkansas and Mississippi to describe their attitudes and care practices related to PLWAs. Respondents who were more comfortable treating PLWAs had significantly lower avoidance scores and significantly higher empathy scores than respondents with lower comfort levels in providing care. Greater than 80% of respondents indicated that they would provide health care to HIV-infected individuals. Respondents who referred HIV/AIDS patients for all care did so primarily due to lack of experience with HIV and the availability of more experienced providers. Avoidance and empathy scores were not found to be significantly associated with referral for care. This study suggests that this group of providers has relatively low avoidance and high empathy toward PLWAs and is willing to care for HIV-infected individuals.     

Knowledge and attitudes toward HIV/AIDS and risky sexual behaviors among Caribbean African American female adolescents.

The incidence of HIV/AIDS among African Americans in culturally blended south Florida constantly challenges the health care community to reconsider prevention efforts. Very few studies examine the Caribbean population. This study was performed to identify and describe knowledge and attitudes toward HIV/AIDS and risky sexual behaviors in Caribbean African American female adolescents. Three focus group sessions were conducted using a sample of 22 adolescents. The questions included, "What do you know about HIV/AIDS?" "How would a friend's diagnosis of HIV affect your friendship?" and "Why do your peers engage in risky sexual behaviors?" Adolescents abstained from sexual activity mainly because of parental fear and church teachings. Some had accurate knowledge of HIV/AIDS, but all expressed reluctance to share space and personal items with an HIV/AIDS-infected friend. Sharing personal items with a close friend is a common Caribbean practice. This unwillingness suggests a need and direction for further inquiry.     

HIV/AIDS information and services: the situation experienced by adolescents with disabilities in Rwanda and Uganda

Purpose. The study had 2 aims: (1) To explore whether knowledge about HIV and AIDS was similar among adolescents with disabilities compared with their non-disabled peers; and (2) To determine factors which may increase vulnerability of disabled adolescents to HIV infection and/or inappropriate access to HIV related services.

Method. A qualitative study using focus group discussions and semi-structured interviews was conducted with purposefully selected participants in Rwanda and Uganda. The participants included disabled adolescents, non-disabled adolescents, parents, teachers, members of disabled people's organisations and representatives of HIV/AIDS organisations. Interviews explored issues of HIV/AIDS knowledge, access to HIV/AIDS services and perceptions of personal risk.

Results. Barriers preventing adequate access to information about HIV and AIDS experienced by adolescents with disabilities depended on the nature and severity of the impairment. For example, parents and health workers were unable to communicate with deaf adolescents using sign language, adolescents with physical impairments were often unable to access community meetings about HIV and print material was not adapted for those with visual impairments. Further, assumptions by health workers and community members that people with disabilities were not sexually active lead to the marginalisation of disabled people from HIV services. Adolescents with disability described low self esteem and issues of self efficacy affecting control of safer sexual relationships. A high level of targeted abuse, rape and exploitation was reported leading to vulnerability among this population.

Conclusion. The impact of the HIV epidemic among people with disabilities is a neglected area. This study supports the need to develop strategies in HIV prevention programmes that include people with disabilities.     

HIV/AIDS information and services: The situation experienced by adolescents with disabilities in Rwanda and Uganda

Purpose.?The study had 2 aims: (1) To explore whether knowledge about HIV and AIDS was similar among adolescents with disabilities compared with their non-disabled peers; and (2) To determine factors which may increase vulnerability of disabled adolescents to HIV infection and/or inappropriate access to HIV related services.

Method.?A qualitative study using focus group discussions and semi-structured interviews was conducted with purposefully selected participants in Rwanda and Uganda. The participants included disabled adolescents, non-disabled adolescents, parents, teachers, members of disabled people's organisations and representatives of HIV/AIDS organisations. Interviews explored issues of HIV/AIDS knowledge, access to HIV/AIDS services and perceptions of personal risk.

Results.?Barriers preventing adequate access to information about HIV and AIDS experienced by adolescents with disabilities depended on the nature and severity of the impairment. For example, parents and health workers were unable to communicate with deaf adolescents using sign language, adolescents with physical impairments were often unable to access community meetings about HIV and print material was not adapted for those with visual impairments. Further, assumptions by health workers and community members that people with disabilities were not sexually active lead to the marginalisation of disabled people from HIV services. Adolescents with disability described low self esteem and issues of self efficacy affecting control of safer sexual relationships. A high level of targeted abuse, rape and exploitation was reported leading to vulnerability among this population.

Conclusion.?The impact of the HIV epidemic among people with disabilities is a neglected area. This study supports the need to develop strategies in HIV prevention programmes that include people with disabilities.     

African American adolescent perceptions of vulnerability and resilience to HIV.

HIV/AIDS is growing at a disproportional rate among African American adolescents. This trend has occurred despite the fact that 89% of schools have educational programs on HIV/AIDS. Barriers to effective HIV prevention may be related to a failure to develop educational programs based on the cultural competencies of vulnerable populations such as adolescents who are at risk for HIV. The purpose of this qualitative study was to explore African American adolescent perceptions of vulnerability and resilience to HIV/AIDS within a cultural competency paradigm. A group of 8 adolescents at an African American church participated in a focus group to discuss vulnerability and resilience to HIV. To facilitate discussion, the adolescents developed collages from pictures in African American magazines. Content analysis was used to identify themes. The themes revealed were confidence, safe social activities, innocence, image, music/drug culture, and peer pressure.     

Community-based participatory research to prevent substance abuse and HIV/AIDS in African-American adolescents

Adolescence is a time for exploration and risk-taking; in today's urban environment, with the twin threats of substance abuse and HIV/AIDS, the stakes are particularly high. This paper describes a community-based participatory research project to design, implement, and evaluate a faith-based substance abuse and HIV/AIDS prevention program for African-American adolescents. A coalition of university-based investigators and African-American church member stakeholders collaborated on all aspects of Project BRIDGE, the 3-year intervention to reduce substance abuse and HIV/AIDS in African-American adolescents. Our results support the use of community-based participatory research to create desirable change in this setting. Adolescents who participated in Project BRIDGE reported significantly less marijuana and other drug use and more fear of AIDS than a comparison group. Project BRIDGE has been designated an official ministry of the church and the program has been extended to others in the larger metropolitan community. The church now has a well-trained volunteer staff University faculty developed skills in negotiating with community-based settings. The coalition remains strong with plans for continued collaborative activities.     

Community-based participatory research to prevent substance abuse and HIV/AIDS in African-American adolescents

Adolescence is a time for exploration and risk-taking; in today's urban environment, with the twin threats of substance abuse and HIV/AIDS, the stakes are particularly high. This paper describes a community-based participatory research project to design, implement, and evaluate a faith-based substance abuse and HIV/AIDS prevention program for African-American adolescents. A coalition of university-based investigators and African-American church member stakeholders collaborated on all aspects of Project BRIDGE, the 3-year intervention to reduce substance abuse and HIV/AIDS in African-American adolescents. Our results support the use of community-based participatory research to create desirable change in this setting. Adolescents who participated in Project BRIDGE reported significantly less marijuana and other drug use and more fear of AIDS than a comparison group. Project BRIDGE has been designated an official ministry of the church and the program has been extended to others in the larger metropolitan community. The church now has a well-trained volunteer staff. University faculty developed skills in negotiating with community-based settings. The coalition remains strong with plans for continued collaborative activities.     

AIDS and prehospital personnel: knowledge and prevention of occupational exposure

OBJECTIVES: Prehospital personnel, including law enforcement officers, paramedics, and fire-fighters, may be exposed to the human immunodeficiency virus (HIV) while working. This study of prehospital personnel sought to determine: 1) their knowledge of the acquired immune syndrome (AIDS) and HIV transmission; 2) the extent of AIDS training received; 3) self-assessment of risk for HIV infection; and 4) precautions adopted to reduce occupational risk of exposure to HIV. METHODS: A survey was administered to pre-hospital personnel in a large Southern California jurisdiction. The response rate was 41% (n = 1,756) in 10 city and county departments where respondents were employed. Law enforcement officers (44%), firefighters (44%), and paramedics (12%) comprised the sample. RESULTS: Respondents had accurate knowledge about AIDS, but incorrect perceptions about HIV transmission. A minority believed that HIV could be contracted from casual contact. Training relating to AIDS was not frequent. Preventive practices were infrequent in the work setting, with precautions used less than 50% of the time on eight of 10 measures. One-third of these prehospital personnel assessed their risk for HIV infection as medium to high, largely attributable to fear of occupational exposure. CONCLUSIONS: Improved educational programs regarding HIV/AIDS are needed for prehospital personnel to increase the use of preventive occupational practices in the field.     

AIDS and adolescents. How can you help them reduce their risk?

AIDS in adolescents (0.4% of all cases) is a problem of increasing importance in the United States. Infection with the human immunodeficiency virus (HIV) exists in high schools and on university campuses, and it presents a real and immediate threat to teenaged Americans who engage in drug abuse and sexual activity. Appropriately targeted educational efforts are needed to limit HIV transmission among adolescents. Most adolescents are aware of the high-risk activities that may lead to HIV transmission. However, only about one third alter their sexual behavior to avoid AIDS. It is important to move beyond imparting knowledge about AIDS transmission and to move toward changing risky behavior. Strategies for AIDS risk reduction in adolescents should be implemented now across the country. Appropriate support and intervention are urgently needed for adolescents at high risk.     

HIV/AIDS knowledge and self-esteem among adolescents

The incidence of HIV/AIDS is rapidly increasing among adolescents and young adults with some studies linking sexual risk taking and self-esteem. A convenience sample of 39 ethnically diverse adolescents, ages 14-18, participated in a pilot study designed to assess HIV/AIDS knowledge and to build self-esteem. Adolescents selected from two centers in California completed the Coopersmith Self-Esteem Inventory and the Student Health Questionnaire (SHQ) before beginning and after completing a program of six 2-hour educational sessions. These sessions focused on HIV/AIDS knowledge and building self-esteem. Knowledge of HIV/AIDS prevention and transmission increased by 2096 from pretest to posttest. Practitioners addressing the needs of adolescents should focus on in-depth information regarding HIV/AIDS, especially in the area of prevention strategies and cultural factors influencing levels of self-esteem.     

HIV/AIDS and the workplace: perceptions of nurses in a public hospital in South Africa

AIM: The purpose of this article is to report a study of the perceptions and experiences of nurses caring for people living with HIV/AIDS in the public health sector in South Africa. BACKGROUND: The number of people living with HIV/AIDS in South Africa has escalated at an alarming rate. Many people being hospitalized are HIV positive, and hence nurses are in more regular and prolonged contact with people suffering from HIV/AIDS than is the case in other working environments. Although studies focusing on nurses' experiences of caring for patients with HIV/AIDS have been done in numerous countries, little is known about nurses' views in Africa, and South Africa in particular. To ensure quality care for patients with HIV/AIDS, it is important to understand nurses' experiences of nursing HIV-positive patients and how they may influence their attitudes towards these patients. METHOD: A qualitative approach was used, the primary method of data collection being in-depth interviews. These interviews were conducted with 35 nurses at a public hospital in the Gauteng province of South Africa in 2002-2003. FINDINGS: Seven themes were identified: helplessness, emotional stress and fatigue, fear, anger and frustration, occupational-related concerns, empathy, and self-fulfilment. CONCLUSIONS: Increased understanding of the stresses and rewards experienced by these nurses can contribute to policy development in this area. It is also important to provide appropriate preregistration and continuing education and support for nurses working in this field, and to ensure that the working environment is adequate in terms of resources.     

Knowledge and Attitudes about HIV/AIDS among Homoeopathic Practitioners and Educators in India

This study is designed to assess AIDS knowledge among Homeopathy educators and physicians in India, which has not been evaluated previously. India now has the largest number of HIV infected persons worldwide, with an estimated cumulative 5.1 million infections. Homeopathy is the dominant system among the nationally-recognized alternative or complementary systems of medicine, which collectively provide health care to around 600 million people in India. Homeopathy, with its holistic and patient-centered approach, has a wide reach to people at risk of contracting human immunodeficiency virus (HIV). Participants were 68 homeopathy physicians (34 educators and 34 practitioners) who completed a CDC questionnaire measuring HIV/AIDS Knowledge regarding AIDS. This study reports the current level of knowledge of, and attitudes about, HIV/AIDS among homeopathy educators and practitioners. These findings will assist in the development of an education module to equip homeopathic health care personnel to impart accurate AIDS information and prevention counseling to their patients in an efficient manner.     

教育指导提高艾滋病患者抗病毒治疗的效果观察

目的探讨有效的教育指导方法,提高我国艾滋病患者抗病毒治疗效果。方法对我院103例艾滋病患者开始抗病毒治疗前及治疗1、3、6、9、12个月末进行教育指导。结果患者对疾病及药物治疗的认知程度显著改善,治疗过程中未出现擅自停、换药物和私自退出治疗的情况,病毒复制被控制,实现了免疫功能重建。结论优质的教育指导能够使患者保持良好的服药依从性,取得最佳的抗病毒治疗效果,提高患者生存质量。     

云南省红河州某哈尼族聚居地区人群艾滋病病毒感染状况及危险因素认知调查分析

目的了解红河州哈尼族聚居地区人群艾滋病病毒(HIV)感染状况、艾滋病相关知识知晓情况及面临的危险因素,为在该人群中开展艾滋病防治工作提供科学依据。方法对15～49岁哈尼族人群进行问卷调查,收集社会人口学、艾滋病相关知识、性行为等信息;采集7 ml静脉血检测HIV、梅毒螺旋体和Ⅱ型单纯疱疹病毒感染。结果 1001名哈尼族村民中有小学及小学以下文化程度者占61.0%;仅有32.8%的村民听说过艾滋病,3种艾滋病传播途径的正确回答率34.2%,日常生活是否传播艾滋病的正确回答率为9.8%,有关艾滋病传播途径的问题正确回答率18.2%,艾滋病相关知识全部正确回答率8.8%。41.7%的村民有外出务工史,71.4%的村民外出务工期间有过配偶外性伴。HIV阳性率0.6%,梅毒阳性率2.9%,Ⅱ型单纯疱疹阳性率43.7%。结论哈尼族村民受教育程度低下,艾滋病防治知识整体知晓率低,获得艾滋病相关知识的途径有限、普遍存在多性伴习俗,外出务工者是哈尼族聚居地区传播艾滋病的主要桥梁人群。制定针对哈尼族人群预防艾滋病传播健康教育和防治干预措施十分必要。     

浙江省台州地区50岁及以上HIV/AIDS病例流行病学分析

目的 描述浙江省台州地区≥50岁艾滋病病毒感染者及艾滋病患者(HIV/AIDS)流行特点,为制定针对性艾滋病防治措施提供依据.方法 收集台州地区1996-2010年的≥50岁人群艾滋病疫情报告资料,对病例分布特点、传播途径构成及发现途径等进行分析.结果 台州地区累计报告≥50岁人群HIV/AIDS 88例感染者,...     

HIV/AIDS and disability: differences in HIV/AIDS knowledge between deaf and hearing people in Nigeria

PURPOSE. Studies both in North America and Europe have found that deaf individuals lack access to AIDS information, due to problems in communication, low literacy and tightly woven social networks within the deaf community. However few comparable studies are available from countries in the Developing World. The present study was undertaken in Nigeria where there is an estimated adult HIV prevalence rate of 5.4%. We sought to compare HIV knowledge among deaf and hearing individuals in order to identify how effectively deaf members of the community are being reached by HIV/AIDS messages. METHODS. A survey comparing knowledge about HIV/AIDS among deaf and hard of hearing adolescents (n = 50) and young adults (n = 50) was undertaken. RESULTS. Significant differences (p < 0.05) in levels of understanding about certain aspects of how AIDS is spread were identified as well as differences in available resources for access to accurate information among deaf members of the population. CONCLUSION. These findings from Nigeria speak strongly to the need for the development of interventions that include people with disabilities in public health and HIV/AIDS strategies and that address their specific vulnerabilities. Evaluating the adaptation of education material and the inclusion of the deaf population in HIV awareness programmes is an urgent 'next step.'     

Learners' knowledge and and perceptions of voluntary counselling and testing for HIV and AIDS in the Free State Province

The study investigated the perceptions of the youth regarding Voluntary Counselling and Testing (VCT) and sexual aspects related to HIV and AIDS. The study was grounded in qualitative methodology, using 4 focus group interviews for data collection triangulating the results with field notes and literature. The participants of the four focus groups proved to be well informed on the topic and had clear perceptions concerning several aspects. They were very positive regarding the advantages of VCT for the prevention and management of HTV and AIDS. The participants recognised the need for the youth to be better informed about VCT and HIV and AIDS. They were much concerned by the lack of parental involvement in sexual education as well as the permissiveness of the youth who partook in alcohol and drug abuse as well as prostitution. Participants of the study stated that this problem was exacerbated by poverty and poor socio economic conditions.     

HIV/AIDS, nurses, and the black church: a case study.

Historically, the Black church has participated by lending support, providing care, and being actively involved in the health and social welfare of its members. However, since the epidemic impact of HIV/AIDS in the Black community, the church has been sharply criticized for its lukewarm response and involvement. Nurses are in a unique position to participate in educating the Black community about HIV/AIDS through the church. This article provides an insight into the response by the Black church to the disease and the potential role of nurses in faith communities, and offers recommendations for planning an HIV/AIDS program and a list of helpful resources.     

HIV Knowledge and Practices Among Rural South Africans

PURPOSE: To explore the knowledge and practices related to HIV/AIDS by rural South Africans in Limpopo Province. DESIGN AND METHODS: Qualitative research methods were used. Twenty-eight key and general informants participated in individual interviews in summer 2001. The setting was a hospital-based HIV clinic in rural Limpopo Province. FINDINGS: All participants were members of a support group, and they had basic knowledge about HIV/AIDS; however, participants indicated that they lacked basic knowledge of HIV/AIDS until they joined the support group. CONCLUSIONS: Support groups were effective in educating people about HIV/AIDS.