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PubMed2006

Effectiveness of an HIV/AIDS educational programme for Chinese nurses.

AIM: This paper reports a study examining the effect of a multifaceted HIV/AIDS educational intervention on the knowledge, attitudes and willingness of Chinese nurses in caring for patients with human immunodeficiency virus. BACKGROUND: The expanding HIV/AIDS epidemic challenges nurses to increase their knowledge about this devastating illness to provide effective HIV/AIDS prevention and care to their patients. HIV/AIDS educational interventions, which were developed for North American and European nurses, have not been studied among nurses in other societies. METHODS: The study employed a pretest, post-test experimental design with 208 nurses from seven Chinese provinces. The intervention consisted of a 5-day workshop comprising didactic lectures interspersed with activities designed to elicit discussion of participants' values and personal feelings about HIV/AIDS. Bloom's Taxonomy and principles of good HIV/AIDS educational practice guided the educational intervention. Outcome variables were HIV/AIDS knowledge, attitude toward patients with HIV/AIDS (including empathy for and desire to avoid these patients) and willingness to provide nursing care to these patients. The data were collected in 2003. FINDINGS: At baseline, HIV/AIDS knowledge was not high and attitudes and willingness to care were neutral. Knowledge, attitudes toward patients with HIV/AIDS and willingness to provide nursing care to these patients were each improved at the conclusion of the workshop (P<0.001). CONCLUSIONS: As the HIV/AIDS epidemic expands, nurses will be called upon to deliver competent, compassionate and comprehensive care to patients and their significant others. Intensive, interactive HIV/AIDS professional workshops can contribute to the national effort by increasing knowledge and improving attitudes towards and willingness to provide nursing care for patients with HIV/AIDS.

China↗

PubMed2004

Stigma, discrimination, and HIV/AIDS knowledge among physicians in Barbados.

OBJECTIVE: To determine the extent of clinical knowledge of HIV/AIDS that physicians in Barbados have and their attitudes towards persons living with HIV/AIDS. METHODS: In 2000 the Barbados Association of Medical Practitioners conducted a survey in order to assess its members' views on HIV/AIDS issues. Over a two-month period 203 physicians (76% of all those practicing in the country) were interviewed. The survey included physicians working in private practice and the public sector. They were surveyed individually concerning their attitudes towards counseling as well as their clinical knowledge, perception of safe practices, fear of occupational exposure, views on ethical issues, experience treating HIV/AIDS patients, and background with HIV/AIDS continuing education. RESULTS: In comparison to physicians who had graduated in later years, physicians who had graduated in 1984 or earlier had seen fewer HIV/AIDS clients, had lower levels of knowledge about the disease, were more likely to test for HIV/AIDS without informed consent, and were less likely to have ever attended a continuing education training course on HIV/AIDS. Overall, knowledge of the clinical indications of HIV/AIDS was low, and 76% of the physicians did not think they had adequate counseling skills. Over 80% of the physicians were comfortable looking after HIV/AIDS patients. While 95% of the physicians would not release HIV test results without a patient's consent, 33% would test, without consent, a seriously ill patient, and 15% would test without consent a patient upon whom they had to perform an invasive procedure if they perceived the patient to be from a high-risk population such as gay men or commercial sex workers. Only 53% of the physicians had attended an HIV/AIDS in-service training program between 1995 and 1999. CONCLUSIONS: Physician training in Barbados should focus on all aspects of HIV/AIDS care, including clinical and emotional factors. Attendance at such training should be mandatory for public sector physicians, and medical school curricula need to be examined to ensure their HIV/AIDS content is current and comprehensive.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Enhancing the evidence base for HIV/AIDS control in India.

An optimum evidence base is necessary for the effective control of HIV/AIDS in India, as the lack of an adequate evidence base on critical issues leads to controversy and hurdles. To assess the trends in the HIV/AIDS evidence base for India, a PubMed literature search for publications from India in 2002 and 2003 on HIV/AIDS was done, and abstracts from India in one major international HIV/AIDS conference in 2002, and presentations at one major HIV/AIDS conference in India in 2003 were reviewed. The PubMed search revealed 145 papers with abstracts on HIV/AIDS from India during this period, which was 1.4% of the worldwide HIV/AIDS publications. Of these 145 publications, 124 (85.5%) were based on original research and, of these, 27.4% were in the basic sciences, 62.9% in the clinical sciences, and 9.7% in the public health sciences; 53.2% of the original research papers were published in journals with impact factors ranging from 0 to 1. Many vital issues for HIV control, such as validation of the methods used to assess HIV burden in the population, large-scale impact assessment of HIV prevention programmes, cost-effectiveness of HIV interventions, and critical evidence-to-policy issues, were not covered. Of the 8824 abstracts accepted for presentation at the XIV International AIDS Conference 2002 at Barcelona, 8% were from India--a fair representation given that India has about 10% of the world's HIV burden. However, the utility of this information is severely limited with the majority of it not getting translated into detailed papers in the peer-reviewed literature for widespread scrutiny and use. The views expressed by many experts at the Fourth International Conference on AIDS India 2003 at Chennai were impressive, but the presentation and discussion on original research data from India were sparse. From these various sources, it is estimated that the available evidence base for HIV/AIDS control in India is suboptimal. Using certain assumptions, it is estimated that to provide an adequate evidence base for the control of HIV/AIDS in India, quality original HIV/AIDS research in India would have to double in the basic and clinical sciences, and increase by more than 5 times for the public health sciences. Enhancingthis evidence base to an optimum level would require optimizing its demand, systematically planning its supply locally in India and creating an environment suitable for its development. To effectively control HIV/AIDS in India, strategic planning is needed to develop an evidence base that covers all critical areas where information is needed. Formation of a Society for HIV/AIDS Research in India by involving all the major stakeholders could help build up momentum towards establishing a comprehensive, relevant, dynamic and long-term evidence base that provides rigorous and timely information needed for HIV/AIDS control.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Impact of HIV/AIDS on care and outcomes of severe sepsis.

INTRODUCTION: There has been dramatic improvement in survival for patients with HIV/AIDS; however, some studies on patients with HIV/AIDS and serious illness have reported continued low rates of intensive care. The purpose of this study was to examine patterns of care and outcomes for patients with severe sepsis and HIV/AIDS and compare them with those of patients with severe sepsis without HIV/AIDS. METHODS: We assessed data from all 1999 discharge abstracts from all non-federal hospitals in six US states. Patient demographic characteristics, discharge diagnoses, resource use, and outcomes were extracted. Analyses were performed using chi-square, Wilcoxon rank sum, or regression techniques, as appropriate. RESULTS: We identified 74,020 patients with severe sepsis (7,638 (10.3%) had HIV/AIDS) using ICD-9-CM codes. Patients with severe sepsis and HIV/AIDS had a similar mean length of stay (16.9 days versus 17.7 days; p = 0.0669), had lower mean hospitalization cost (24,382 dollars versus 30,537 dollars; p < 0.0001), were less likely to be admitted to the intensive care unit (37% versus 56%; p < 0.0001), and had a greater mortality (29% versus 20%; p < 0.0001) than those without HIV/AIDS. After adjustment for cohort differences, patients with severe sepsis and HIV/AIDS had increased likelihood of death (OR (95% CI) = 2.41 (2.23-2.61)) and were substantially less likely to be admitted to the intensive care unit (OR (95% CI) = 0.54 (0.51-0.59)). When compared with those with severe sepsis and HIV/AIDS, patients with severe sepsis without HIV/AIDS were universally more likely to be admitted to the intensive care unit, even when they had comorbid illnesses with equal or worse expected in-hospital mortality (e.g., metastatic cancer). CONCLUSION: For patients with severe sepsis, there are differences in care and outcomes for those with HIV/AIDS. Further research is needed to examine the delivery of care for patients with severe sepsis and HIV/AIDS.

Adult↗

PubMed1991

Changing patterns in the workload of a district HIV/AIDS counselling unit 1987-90.

OBJECTIVES: To describe the changing workload of an HIV/AIDS counselling unit between 1987 and 1990. DESIGN: Retrospective examination of data collected by the HIV/AIDS counselling unit between 1987-90 on the number of counselling sessions with patients, family members and staff. SETTING: An HIV/AIDS counselling unit established in 1987 in a London teaching hospital. MAIN OUTCOME MEASURES: Number of new referrals to the HIV/AIDS counselling unit and the number of follow-up sessions. Number of counselling sessions with family members, hospital staff and people making telephone contact with the unit. RESULTS: New referrals to the HIV/AIDS counselling unit increased from 117 (1987-88) to 926 (1989-90). Follow-up appointments increased from 403 to 2016 in the same period. Telephone counselling sessions increased five-fold, and counselling sessions with family members nearly ten-fold over the three year period. Staff consultations doubled. CONCLUSION: The increase in the HIV/AIDS counselling unit's workload may be partly attributable to the rising incidence of AIDS in the community, reflecting earlier patterns of HIV infection. In addition, new HIV/AIDS services were developed in the hospital between 1987 and 1990. These included the establishment of a same-day HIV test and result clinic; integrated management of patients with HIV/AIDS, with an emphasis on early intervention in HIV infection; specialist services for families, antenatal clinic attenders and others affected by HIV; and the appointment of a designated HIV/AIDS consultant. New approaches to counselling and training health care providers in counselling skills will assume increasing importance in meeting future demand for HIV/AIDS counselling.

AIDS Serodiagnosis↗

PubMed2006

Can biomedical and traditional health care providers work together? Zambian practitioners' experiences and attitudes towards collaboration in relation to STIs and HIV/AIDS care: a cross-sectional study.

BACKGROUND: The World Health Organization's World health report 2006: Working together for health underscores the importance of human resources for health. The shortage of trained health professionals is among the main obstacles to strengthening low-income countries' health systems and to scaling up HIV/AIDS control efforts. Traditional health practitioners are increasingly depicted as key resources to HIV/AIDS prevention and care. An appropriate and effective response to the HIV/AIDS crisis requires reconsideration of the collaboration between traditional and biomedical health providers (THPs and BHPs). The aim of this paper is to explore biomedical and traditional health practitioners' experiences of and attitudes towards collaboration and to identify obstacles and potential opportunities for them to collaborate regarding care for patients with sexually transmitted infections (STIs) and HIV/AIDS. METHODS: We conducted a cross-sectional study in two Zambian urban sites, using structured questionnaires. We interviewed 152 biomedical health practitioners (BHPs) and 144 traditional health practitioners (THPs) who reported attending to patients with STIs and HIV/AIDS. RESULTS: The study showed a very low level of experience of collaboration, predominated by BHPs training THPs (mostly traditional birth attendants) on issues of safe delivery. Intersectoral contacts addressing STIs and HIV/AIDS care issues were less common. However, both groups of providers overwhelmingly acknowledged the potential role of THPs in the fight against HIV/AIDS. Obstacles to collaboration were identified at the policy level in terms of legislation and logistics. Lack of trust in THPs by individual BHPs was also found to inhibit collaboration. Nevertheless, as many as 40% of BHPs expressed an interest in working more closely with THPs. CONCLUSION: There is indication that practitioners from both sectors seem willing to strengthen collaboration with each other. However, there are missed opportunities. The lack of collaborative framework integrating maternal health with STIs and HIV/AIDS care is at odds with the needed comprehensive approach to HIV/AIDS control. Also, considering the current human resources crisis in Zambia, substantial policy commitment is called for to address the legislative obstacles and the stigma reported by THPs and to provide an adequate distribution of roles between all partners, including traditional health practitioners, in the struggle against HIV/AIDS.

Journal Article↗

PubMed1997

Knowledge and Attitudes of Certified Athletic Trainers in Pennsylvania Toward HIV/AIDS and Treating HIV-Positive Athletes.

OBJECTIVE: As the number of people infected with the Human Immunodeficiency Virus (HIV) continues to increase so does the likelihood that athletic trainers will treat HIV-positive athletes. The purposes of this study were to determine how knowledgeable certified athletic trainers in Pennsylvania are about HIV/ AIDS and their attitudes toward treating the injuries of HIV- positive/AIDS athletes. Another purpose of this study was to determine what effect the athletic trainers' HIV/AIDS attitudes had on their HIV/AIDS knowledge level. DESIGN AND SETTING: A questionnaire was mailed to 807 NATA-certified athletic trainers who resided in the state of Pennsylvania. A total of 410 (50.8%) athletic trainers participated in the study: 241 (58.8%) males and 169 (41.2%) females. SUBJECTS: NATA-certified athletic trainers who resided in the state of Pennsylvania as of March 19, 1994. MEASUREMENTS: A questionnaire was developed by the investigators after reviewing the appropriate literature and in consultation with a panel of experts that consisted of athletic trainers, physicians, and a health educator who specialized in HIV/AIDS education. The questionnaire consisted of three sections: demographic information, HIV/AIDS knowledge, and HIV/AIDS attitude. Returned questionnaires were analyzed via descriptive (frequencies, percentages, and means) and inferential statistics. Univariate analysis consisted of independent t tests to determine what effect the athletic trainers' HIV/AIDS attitudes had on their HIV/AIDS knowledge level. RESULTS: NATA-certified athletic trainers in Pennsylvania are moderately knowledgeable about HIV/AIDS and have constructive attitudes in treating the athletic injuries of HIV-positive/ AIDS athletes. Their major concern, however, is fear of HIV transmission. It was further determined that differences in HIV/AIDS attitudes had no effect on HIV/ AIDS knowledge level. CONCLUSIONS: The likelihood that athletic trainers will treat HIV-positive athletes is ever increasing. HIV/AIDS education and appropriate clinical precautions are paramount in protecting the clinician and athlete alike.

Journal Article↗

PubMed2006

HIV/AIDS knowledge, women's education, epidemic severity and protective sexual behaviour in low- and middle-income countries.

A fundamental public health strategy to reduce the risk of HIV/AIDS is to increase levels of awareness and knowledge about the disease. Although knowledge about HIV/AIDS and protective sexual behaviour are linked theoretically, relatively little is known about their empirical relationship. Using Demographic and Health Survey data from 23 low- and middle-income countries, this study used multilevel logistic regression models: to examine cross-national variability in the relationship between HIV/AIDS knowledge and protective behaviour (condom use and restricted sex); to investigate the moderating influences of women's educational attainment on this relationship; and to test the extent to which severity of the HIV/AIDS epidemic accounts for cross-national variability in the association between HIV/AIDS knowledge and protective behaviour. There was an association between increased knowledge of HIV/AIDS and condom use that varied in strength and form cross-nationally. This cross-national variation was accounted for partially by the socioeconomic characteristics of women resident in the study countries and between-country differences in the severity of the HIV epidemic. While education modified the association between HIV/AIDS knowledge and protective behaviour--stronger associations at lower levels of education--epidemic severity exerted a stronger influence on behaviour than any other characteristic. Finally, this study indicates that protective sexual practices are disturbingly low. In eight of 23 countries, overall levels of condom use to prevent STDs and HIV/AIDS were less than 5.0%. Waiting for the spread of HIV/AIDS infection to change sexual practices in low- and middle-income countries will result in dramatic unnecessary suffering.

Acquired Immunodeficiency Syndrome↗

PubMed2006

Changes in religiousness and spirituality attributed to HIV/AIDS: are there sex and race differences?

BACKGROUND/OBJECTIVE: Having a serious illness such as HIV/AIDS raises existential issues, which are potentially manifested as changes in religiousness and spirituality. The objective of this study was (1) to describe changes in religiousness and spirituality of people with HIV/AIDS, and (2) to determine if these changes differed by sex and race. METHODS: Three-hundred and forty-seven adults with HIV/AIDS from 4 sites were asked demographic, clinical, and religious/spiritual questions. Six religious/spiritual questions assessed personal and social domains of religiousness and spirituality. RESULTS: Eighty-eight participants (25%) reported being "more religious" and 142 (41%) reported being "more spiritual" since being diagnosed with HIV/AIDS. Approximately 1 in 4 participants also reported that they felt more alienated by a religious group since their HIV/AIDS diagnosis and approximately 1 in 10 reported changing their place of religious worship because of HIV/AIDS. A total of 174 participants (50%) believed that their religiousness/spirituality helped them live longer. Fewer Caucasians than African Americans reported becoming more spiritual since their HIV/AIDS diagnosis (37% vs 52%, respectively; P<.015), more Caucasians than African Americans felt alienated from religious communities (44% vs 21%, respectively; P<.001), and fewer Caucasians than African Americans believed that their religiousness/spirituality helped them live longer (41% vs 68% respectively; P<.001). There were no significantly different reported changes in religious and spiritual experiences by sex. CONCLUSIONS: Many participants report having become more spiritual or religious since contracting HIV/AIDS, though many have felt alienated by a religious group-some to the point of changing their place of worship. Clinicians conducting spiritual assessments should be aware that changes in religious and spiritual experiences attributed to HIV/AIDS might differ between Caucasian and African Americans.

Adult↗

PubMed2006

Effect of HIV/AIDS on the control environment.

OBJECTIVE: The management of organizations is responsible for risk management and control systems. HIV/AIDS could be a great threat in the achievement of strategic business objectives, implicating a great concern for management. Management needs to understand this possible risk. This study aims to identify the effect that HIV/AIDS could have on the different elements of the control environment. METHODOLOGY: The archival research method was used. It was established that no formal research was conducted to date on the effect of HIV/AIDS on the control environment as a whole. Various studies have included the effect of HIV/AIDS on certain factors of the control environment. These studies will be discussed briefly to identify relevant findings. RESULTS: The study indicated that the disease could affect various aspects of the control environment, namely: competency of the workforce (e.g. productivity, quality of work, absenteeism, loss of skills and knowledge, training and recruitment, etc.); organizational structure (e.g. increase use of technology labour, disruption of processes, level of employees affected by the disease); human resource (HR) policies and practices (e.g. legislation applicable, prevention and awareness programmes, compensation and benefits). Research limitation: HIV/AIDS is a relatively new potential risk to organizations. Knowledge of the disease is limited. HIV/AIDS is also a very sensitive issue as people fear the disease and do not like to discuss its existence. Government determined that it should be a non-notifiable disease and the disease is currently greatly stigmatized. The databases of companies investigated by other research studies were not developed to gather all the relevant information. CONCLUSION: Management should be aware that HIV/AIDS poses a possible risk to organizations. Data on the effect of HIV/AIDS should be gathered and used in the decision-making process on how to manage this risk. To be able to fulfil this duty, management first has to determine: whether HIV/AIDS is a risk; the relevant cost involved that the disease is costing the organization; how to control these costs.

Absenteeism↗

PubMed1999

Nigerian university students' knowledge, perceptions, and behaviours about HIV/AIDS: are these students at risk?

The purpose of the study was to determine the knowledge level of undergraduate students of a Nigerian university about HIV/AIDS, their perception of risk of contracting HIV/AIDS based on their sexual behaviour, and to assess how students acquire information about HIV/AIDS. The sample consisted of 380 students from five faculties of the university who volunteered to participate in the study. Participants completed a survey asking about their knowledge about transmission, symptomatology and prevention of HIV/AIDS. The survey included questions about their sexual orientation, past and present sexual practices as well as sources of information about HIV/AIDS. The results indicated that the students were knowledgeable about transmission and symptomatology but there were some misconceptions about the mode of transmission of HIV. Few students identified themselves to be at high risk even though majority of them (92%) were sexually experienced. The study also showed that even though these students are knowledgeable and concerned about contracting HIV/AIDS from their partners, this did not prevent them from engaging in unprotected sexual intercourse. It appears, however, that students are exercising caution when negotiating new sexual relationships, as they are likely to discuss (and insist on) using condoms and ask to have a monogamous relationship. Students obtained information about HIV/AIDS primarily from the media rather than from school classrooms and homes, which suggests a need to increase educational efforts at the university. Many students of this university may be at risk of becoming HIV-infected due to their age bracket, level of sexual activity and past/present sexual behaviors. University faculty can be actively involved in developing and implementing HIV/AIDS education and prevention strategies on their campuses. Health educators must go beyond providing accurate and gender-specific information about HIV/AIDS; they must also help students realistically assess their own risk of infection, and develop communication processes which enable them to negotiate safer sexual practices.

Acquired Immunodeficiency Syndrome↗

PubMed2003

A research-based tool for identifying and strengthening culturally competent and evaluation-ready HIV/AIDS prevention programs.

Recent literature on racial disparities in HIV/AIDS and effective HIV/AIDS health service delivery efforts has underscored the importance of cultural sensitivity, relevance and competence in reducing such disparities and providing effective health service delivery. Less work has been done on the role of cultural competence in the delivery of effective HIV/AIDS prevention programs, perhaps because few such prevention programs aimed at minority populations have to date been demonstrated as effective. This article surveys the various ways that the concept of cultural competence has been studied, extends the concept to the field of HIV/AIDS prevention, and presents a simple-to-use instrument that operationalizes the concept for use with HIV/AIDS prevention programs. The article also explores the idea of evaluation readiness among HIV/AIDS prevention programs in the hope of eventually enlarging the pool of minority-focused HIV/AIDS programs demonstrated as effective. The resultant tool can serve as a research-based framework that: (a) serves as a cost-effective way to select promising programs--especially promising minority-focused programs-for rigorous outcome evaluation; (b) advances the field of HIV/AIDS prevention research by providing a conceptual framework for studying the relationship between cultural competence and program effectiveness; and (c) serves as a framework for building capacity in HIV/AIDS prevention programs, pointing to ways in which such programs can be strengthened.

Cultural Diversity↗

PubMed1994

Characteristics of African-American college students with HIV/AIDS.

This article examines the risky sexual behaviors, condom and drug usage, sexually transmitted diseases (STDs), and attitudes of African-American college students with the human immunodeficiency virus (HIV), which is the precursor of the acquired immunodeficiency syndrome (AIDS). A total of 408 (199 males, 209 females) African-American college students, representing 75% of the students enrolled in a southern university, were surveyed. The results revealed that 3.18% of the students reported having HIV/AIDS. The students with HIV/AIDS exhibited significant deficits in AIDS knowledge, particularly information concerning the transmission of HIV/AIDS. While subjects with HIV/AIDS did not differ from subjects without HIV/AIDS with regard to their perceived risk of being exposed to AIDS or their attitudes about using condoms, a significantly larger percentage of subjects with HIV/AIDS reported that they "always" used condoms with their partner. Nevertheless, subjects with HIV/AIDS were more likely to engage in anal intercourse, experience sex with prostitutes, and use drugs. Sexually transmitted diseases were more prevalent among subjects with HIV/AIDS, and syphilis was found to be the best predictor of HIV/AIDS.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Economic consequences of HIV/AIDS in India.

BACKGROUND: HIV/AIDS is one of the pressing public health problems in India. Available information indicates a rising trend of infection. The impact of HIV/AIDS on the economic front is important as it affects mainly the young, who are in the reproductive age group. We estimated the cost of productivity losses in a lifetime attributable to HIV-related mortality in India in the population of the year 1991 at current HIV infection rates. METHODS: The analysis was done from the societal viewpoint, adopting a discount rate of 5%. To estimate the loss in person-years due to HIV/AIDS, two scenarios were considered. Firstly, the population without HIV/AIDS, and secondly, the population with HIV/AIDS. The difference in person-years lived by the cohort in both populations would provide the person-years lost due to HIV/AIDS. To calculate the person-years lived in each, the life table approach was used. The demographic data from the 1991 Census were used. The population was divided into 15 five-year cohorts and the current age-specific death rates were used. Assumptions regarding HIV incidence rates in urban and rural areas in different age groups were made based on the available data and consensus of experts. The estimate was first done for a cohort of 100,000 population for rural and urban areas and then extrapolated to the population in the different age groups. To convert the person-years lost into monetary terms, minimum wages were estimated to be Rs 14,460 per annum. RESULTS: The total undiscounted life-years lost due to HIV/ AIDS by the present population of India will be 238.4 million years-123.7 million years for urban and 114.7 million years for rural areas. On an average this is 0.4 years lost per person. The life-years lost per case of HIV was 44.4 years. Assuming minimum wages of Rs 14460 as the value of one year, the total economic loss is Rs 3447 billion. The productivity loss per case is Rs 642,024 (US$ 20,710). For an estimated national per capita income of Rs 4252.4 the total economic loss is Rs 1014 billion. If a discount rate of 5% is applied for future losses then the total potential years of life lost will be 23 million-11.3 million for urban and 11.7 million for rural areas. In monetary terms this will be Rs 332.6 billion by minimum wages assumption, and 97.8 billion if the national per capita income is assumed to be the cost of one year. CONCLUSION: HIV/AIDS imposes a significant burden on the economic front. The productivity losses are likely to be an underestimate as the costs of treatment of HIV/AIDS patients, prevention programmes and labour costs have not been taken into account. To decide whether HIV/AIDS needs a high priority int he Indian context, it is necessary to have similar estimates for other important diseases such as tuberculosis and cancer.

Acquired Immunodeficiency Syndrome↗

PubMed2006

Measuring the impact of HIV/AIDS, heart disease and malignant neoplasms on life expectancy in the USA from 1987 to 2000.

OBJECTIVES: Quantifying the impact of a disease on society is an important issue for setting priorities for better allocation of healthcare resources and for evaluating the effectiveness of prevention and control of the disease. STUDY DESIGN: The potential gains in life expectancy due to the elimination of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), heart disease and malignant neoplasms were compared for the US population by age and ethnicity from 1987 to 2000. METHODS: The potential gain in life expectancy after hypothetical elimination of cause-specific deaths is an effective indicator of measuring the impact of a disease on a population. Official age-specific mortality rates, by ethnicity, due to HIV/AIDS, heart disease and malignant neoplasms of the US population from the National Center for Health Statistics were used, and multiple decremental life tables were constructed to find the corresponding potential gains in life expectancy. RESULTS: The potential gains in life expectancy for the US population at birth by complete elimination of HIV/AIDS, heart disease and malignant neoplasms were 0.14, 3.71 and 3.06 years in 1987, respectively. In 1995, the potential gain in life expectancy due to the elimination of HIV/AIDS increased from 0.14 years in 1987 and achieved its highest value (0.41 years), whereas the elimination of heart disease and malignant neoplasms led to potential gains in life expectancy of 3.05 and 3.10 years, respectively. Since 1995, the potential gains in life expectancy at birth by eliminating deaths from HIV/AIDS and heart disease have decreased to 0.13 and 2.67 years, respectively, in 2000. However, the potential gain in life expectancy due to elimination of malignant neoplasms remained relatively stable (3.01 years in 2000). It is well known that HIV/AIDS tends to have a greater impact on people of working age, whereas heart disease and malignant neoplasms have a greater impact on people over 65 years of age. To measure the impact of these diseases on life expectancy in people of working age, a partial multiple decremental life table was constructed and the potential gains in life expectancy were computed by partial or complete elimination of various causes of death during the working years. shows the impact on life expectancy of the US working-age population by eliminating deaths from HIV/AIDS, heart disease and malignant neoplasms by race and sex groups. CONCLUSIONS: Since 1995, there has been a rapid reduction in the burden of HIV/AIDS on the life expectancy for the US population, especially for black males of working age. These results could provide useful information when evaluating public health improvements and allocating resources for future disease control programmes.

Acquired Immunodeficiency Syndrome↗

PubMed1997

Stigmatization, HIV/AIDS, and communities of color: exploring response to human service facilities.

HIV and AIDS are rapidly becoming leading causes of death for men and women in large cities across the US. Epidemiological data indicate that persons of color in particular have been disproportionately affected by HIV/AIDS. The continuing growth in the incidence of HIV/AIDS among persons of color implies that human service facilities will be needed in close proximity. However, there has been little research exploring response to human service facilities associated with HIV/AIDS in communities of color. This paper explores community response to facilities associated with HIV/AIDS by analyzing in-depth interviews with fifteen Vietnamese and Latino/Latina informal opinion leaders in Orange County, California. These interviews indicate that the stigma surrounding HIV/AIDS emanates to a large degree from the social construction of "HIV/AIDS as homosexuality". Even with the deviance and marginalization associated with HIV/AIDS, however, creative coping strategies have been developed by families within the Latino and Vietnamese communities to enable the maintenance of family ties with persons living with HIV/AIDS.

Acquired Immunodeficiency Syndrome↗

PubMed1999

Correlates of HIV/AIDS knowledge among U.S.-born and foreign-born Hispanics in the United States.

No national study of Hispanics has examined variation in HIV/AIDS-related knowledge by ethnicity, place of birth, and duration in the United States (for the foreign born) at least in part because of data constraints. Data from the 1991 and 1992 National Health Interview AIDS Supplements were used to examine the influence of these factors, and other sociodemographic and HIV/AIDS-related variables, on a 25-item HIV/AIDS knowledge scale. Descriptive and multivariate analyses indicate that foreign-born Hispanics with shorter durations in the United States have significantly lower levels of HIV/AIDS knowledge, as do those of Mexican and Cuban ethnicity. Numerous other factors, most of which are known to be associated with HIV/AIDS knowledge in the general population, were found to be significantly associated with HIV/AIDS knowledge among Hispanics in multivariate analyses; these include age, education, gender, rural residence, residence in the West, knowing a person with HIV/AIDS, personal risk for HIV/AIDS, and having been tested for HIV outside of the blood donation system. Results suggest that HIV/AIDS information campaigns targeted to Hispanics may not be equally effective in reaching foreign-born and U.S.-born subgroups or persons of differing ethnicities. Future studies should examine sources of HIV/AIDS information and the mechanisms of knowledge acquisition and transmission within specific subgroups of the Hispanic population.

Journal Article↗

PubMed2005

HIV/AIDS risk factors as portrayed in mass media targeting First Nations, Métis, and Inuit peoples of Canada.

PURPOSE: The purpose of this study was to describe the coverage and portrayal of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) risk factors as framed in newspaper targeting Aboriginal (First Nations, Métis, and Inuit) peoples in canada. METHODS: From a sample of 31 Aboriginal newspapers published in English from 1996 to 2000, 14 newspapers were randomly selected. Of 167 articles published on HIV/AIDS during this time period, all anecdotal (n=34) and an approximate 25% random sample of scientific (n=32) articles were analyzed using both quantitative (coding reliability and frequencies) and qualitative (in-depth content analysis) analyses. RESULTS: Individual risk factors for HIV/AIDS were described in 74%, (49/66) of the articles and included unprotected sexual intercourse (20/49 or 41%), sharing of needles for injection drug use (IDU; 16/49 or 33%), infected blood transfusions (3/49 or 6%), and vertical transmission from mother to a baby (10/49 or 20%). Additional risk factors of alcohol use and poverty were mentioned in 29% and 25% of the articles. In addition to the well-recognized HIV/AIDS risk groups of prostitutes and homosexual men, sexual abuse victims, prisoners, and women were identified in aboriginal newspapers as being at risk. Although Aboriginal women were identified as being at high risk, the newspaper coverage also emphasized their lack of knowledge regarding HIV/AIDS. Heterosexual men were not mentioned as being at risk for HIV/AIDS in the newspaper articles. BACKGROUND: The prevalence of HIV/AIDS is higher among Canadian Aboriginals than in the general population. Local and community newspapers are an important channels for the dissemination of health information for isolated, rural, and aboriginal communities. INTERPRETATION: The findings show that Aboriginal media identify high-risk groups and individualistic risk factors for HIV/AIDS within a public health perspective.

Attitude to Health↗