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1
Rollason, Gillian K. "The securitization of HIV/AIDS in Thailand and Myanmar." Thesis, Swansea University, 2014. https://cronfa.swan.ac.uk/Record/cronfa43126.
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In January 2000 the United Nations Security Council met to discuss HIV/AIDS. It was the first time the Council had convened solely to consider the security implications of health, a non-traditional security issue. This thesis examines the Copenhagen School theory of securitization, a formulaic tool proposed to bridge the conceptual gap between traditional narrow definitions of security and wider, nontraditional interpretations of the concept. Following a review of the literature, two conclusions are offered; first, that at the heart of the 'radically constructivist' process of securitization is the construction of an existential threat which employs the realist logic of threat and defence. The second conclusion is that this construction am ounts to a suasive process in which fear of a proposed threat and its consequences m ust be invoked within an audience. The application of the theory to health issues, including HIV/AIDS, has facilitated im portant critiques of the ethical consequences of the security linkage and the invocation of fear related to infectious disease is problematic. Using data collected during 13 m onths in Southeast Asia, this thesis investigates whether securitization of HIV/AIDS took place within Thailand or M yanmar following the seminal events at the UNSC. Fifty qualitative interviews were conducted with elite actors in the HIV/AIDS response, including from the United Nations, and the thesis concludes that securitization at the domestic level did not occur in either country. Instead, HIV/AIDS securitization at the UNSC was part of a strategic campaign to mobilise resources for dealing with the epidemic from globally powerful actors. In Thailand and Myanmar, civil society organisations defined the domestic epidemic responses and, being largely comprised of PLWHA, assumed a rights-orientated approach to disease m anagem ent and rejected the threat-defence logic of securitization that could jeopardise their interests.
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Cameron, Michael Patrick. "The Relationship Between Poverty and HIV/AIDS in Rural Thailand." The University of Waikato, 2007. http://hdl.handle.net/10289/2570.
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HIV/AIDS is a global pandemic with critical demographic, economic, and social implications. The pandemic is widespread in poor regions of the world, including Southeast Asia where its long-term effects are potentially catastrophic. Despite the major impacts of the epidemic being already felt at the household level in many countries, a lack of recognition of the socioeconomic determinants of HIV infection and the economic and social impacts of HIV/AIDS and their relationship with poverty persists. This is due in part to the lack of systematic studies at the household, community, sectoral, and macro levels. The thesis describes a 'vicious circle' between HIV/AIDS, poverty and high-risk behaviour at the individual level. In the poverty-HIV/AIDS cycle, HIV-infected individuals are especially vulnerable to poverty, the poor are more likely to engage in high-risk behaviour such as commercial sex work, and high-risk behaviour in turn makes people susceptible to HIV infection. The thesis examines whether rural Northeast Thailand exhibits characteristics that support the existence of such a cycle. Four key relationships are considered and tested: (i) the relationship between previous HIV infection and current wealth or poverty; (ii) the relationship betweem wealth or poverty and HIV/AIDS knowledge; (iii) the relationship between previous wealth or poverty and current HIV infection; and (iv) the relationship between previous migration and current HIV infection. All four relationships are shown to hold using survey data from Khon Kaen province in Northeast Thailand. Poverty is shown to increase susceptibility to HIV infection, and HIV/AIDS is shown to reduce wealth and hence increase poverty. Under the circumstances, the hypothesis that rural Northeast Thailand exhibits characteristics that would suggest the existence of a poverty-HIV/AIDS cycle cannot be rejected. This thesis also provides several key contributions to the literature on HIV/AIDS and poverty. First, it provides quantitative and qualitative empirical analysis of the impacts of HIV/AIDS on households in a moderately affected region of Thailand. Second, it provides empirical analysis both on whether wealth and poverty affect the risk of HIV infection, and whether HIV infection affects wealth and poverty. The results from this thesis also provide significant empirical evidence of the importance of rural-urban migration in the spread of HIV in Asia. Finally, the thesis investigates the potential effects on the poverty-HIV/AIDS cycle of an ongoing socio-economic intervention, namely breaking the poverty-HIV/AIDS cycle via intensive rural development.
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Hast, Am. "Experiences of living with HIV/AIDS in Thailand : A qualitative study." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-20914.
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This thesis and study is sponsored by Minor Field Study scholarship through University of Borås and is funded by SIDA (Swedish International Development Cooperation Agency). There are around half a million people living with HIV/AIDS in Thailand and it is one of Thailand’s most increasing public health diseases since 1984. There are several organizations working jointly with prevention and lifting the level of knowledge among the public and decreasing new infections.The aim of this study is to describe experiences of persons living with HIV or AIDS in Thailand. In-depth interviews was carried out and analysed with a qualitative content analysis. Six persons, three female and three male, aged between 18 to 67 years living with either HIV or AIDS participated. The informants expressed that they were enjoying life and had plans for the future despite of the infection as they felt a sense of wellbeing, had an acceptance of the infection and themselves. It was important to have support from friends and family to cope with life and that support made them feel blessed and grateful. However the informants also expressed a feeling of no self worth and that they had giving up living because of feeling isolated, stigmatized, depressed, ashamed of themselves and being a burden with a sense of guilt that made them repress themselves. The conclusion is that these aspects were interlinked but the negative dominated among these with AIDs and the positive aspects were more common among the informants living with HIV.<br>Program: Sjuksköterskeutbildning
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Wilainuch, Pairote. "Communication between nurses and patients in HIV/AIDS counselling, in Thailand." Thesis, University of York, 2006. http://etheses.whiterose.ac.uk/10985/.
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Phengjard, Johnphajong. "Family caregiving of persons living with HIV/AIDS in urban Thailand /." Thesis, Connect to this title online; UW restricted, 2001. http://hdl.handle.net/1773/7365.
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Gahrén, Jason, and Karin Nyström. "The characteristics of HIV/AIDS-related stigma and discrimination among Thai university students : A questionnaire study." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-200318.
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Introduktion: Nyligen utkomna rapporter visar en ökning i incidensen för nya HIV-infektioner i Thailand och HIV är fortfarande ett av de största hälsoproblemen. Anledningarna till denna utveckling är flera och HIV/AIDS-relaterad stigmatisering och diskriminering poserar som en av de största. Syfte: Syftet med föreliggande arbete var att undersöka karaktärsdragen gällande HIV/AIDS relaterad stigmatisering och diskriminering bland thailändska universitetsstudenter, samt att undersöka förekomsten av eventuella skillnader mellan könen. Metod: En deskriptiv tvärsnittsstudie genomfördes på ett universitet i Prathomthani provinsen, Thailand. Ett bekvämlighetsurval användes. 150 studenter, både män och kvinnor, deltog och svarade på frågor om karaktärsdragen gällande HIV/AIDS-relaterad stigma och diskriminering. Resultat: En låg nivå av rädsla för smittöverföring och sjukdom observerades av majoriteten av studenterna, även om bristande kunskap gällande smittöverföring observerades. Både hög och låg associering med skam, skuld och dom rapporterades och mest utmärkande var frågorna för kvinnliga prostituerade och promiskuitet. Även lågt personligt stöd för diskriminerande åtgärder och principer, och lågt stöd för upplevelse av samhällets inverkan av diskriminerande åtgärder eller politik rapporterades. Slutsats: Studenterna hade en låg nivå av rädsla för smittöverföring och sjukdom, dock uppvisades bristande kunskap gällande smittöverföring. Studenterna rapporterade hög nivå av skam, skuld och dom relaterat till kvinnlig prostitution. Resultaten implicerar behov av vidare interventionsprogram med fokus på kunskap.<br>Introduction: Resent reports indicate an increasing incidence rate of HIV in Thailand and it is still one of the main public health problems. The reasons for this development depend on many different factors where HIV/AIDS-related stigma and discrimination acts as one of the major ones. Aim: The aim of this study was to examine the characteristics of HIV/AIDS-related stigma and discrimination among Thai university students and to investigate if there is any difference in the characteristics with regard to gender. Method: A cross-sectional descriptive study was conducted at a university in Prathomthani Province, Thailand. A convenience sample was used. The 150 students, both male and female, participated to answer questions concerning the characteristics of HIV/AIDS-related stigma and discrimination. Results: Fear of transmission and disease was reported rather low level by the majority of the students, though inaccurate knowledge regarding transmission was observed. The level of shame, blame and judgment were low and high, most distinctive concerning women prostitutes and promiscuity. Low levels of personal support of discriminatory actions and policies, and perceived community support of discriminatory actions or policies were reported. Conclusion: The students had a low amount of fear of transmission and of the disease, though they still demonstrated a lack of knowledge regarding transmission. Women prostitutes related to shame blame and judgment were reported high level by the students. The results imply the need for further intervention programs focusing on information.
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Waitayakul, Chittaya. "Effectiveness of the life skills program for HIV/AIDS prevention in Northern Thai housewives." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2006. https://ro.ecu.edu.au/theses/342.
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This research has applied a Life Skills Program to the health area of HIV/AIDS. The study included both qualitative and quantitative analyses especially designed to establish a strategy to prevent and control HIV/AIDS infection in Thailand. A pseudo-experimental research design was used with pre-test/post-test questionnaires and interviews. The lack of HIV/AIDS knowledge among Thai people and unsafe sexual behaviours place them at risk of acquiring HIV and AIDS. Thus, there is a need to construct a strategy to prevent and reduce the high risk behaviours associated with this infection. The study targeted housewives between the ages of 15 and 60 years living in urban and rural low-income areas in Nakhon Sawan Province in the south of the northern region of Thailand. One hundred housewives participated in the program.
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Gopali, Ram Sharan Adisak Sattam. "Preventive behavior on HIV/AIDS among vocational students in Nongkeam District, Thailand /." Abstract, 2007. http://mulinet3.li.mahidol.ac.th/thesis/2550/cd400/4937994.pdf.
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Casey, Kathleen Barbara. "HIV counselling, mental health and psychosocial care in Thailand." School of Psychology - Faculty of Health and Behavioural Sciences, 2007. http://ro.uow.edu.au/theses/73.
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Rationale: International research has demonstrated that in order to retain a skilled and healthy cadre of willing health-workers there is a need to monitor and develop strategies to mitigate adverse impact of this work and improve the quality and effectiveness of client and patient mental health care. Aims: (i) Monitor and evaluate Thailand’s national HIV mental health and psychosocial care program. (ii) Measure the impact of HIV mental and psychological care on health care providers. (iii) Examine the relationship between occupation-related psychological morbidity and the recruitment, training, clinical supervision and work-practices of HIV mental health service providers. (iv) Develop, implement and evaluate a training curriculum that addresses the demands of the HIV client population in Thailand. Method: In Study 1, 826 government hospitals, 1000 government health centres, and 1135 non-government organisations and private providers participated in: semi-structured, key informant interviews; focussed group discussions; and criterion-referenced appraisals of health policy and service delivery. Study 2, a small exploratory, qualitative study, utilised a schema of five key stressors commonly associated with HIV care to analyse responses gained from HIV counsellors and employed semi-structured interviews and focussed discussion groups. Study 3, a cross-sectional study, explored the relationship between training, work practices, Locus of Control of Behaviour and the self-reporting of signs and symptoms of psychological distress. 803 HIV counsellors completed a series of questionnaires including the Thai version of the General Health Questionnaire (GHQ-28), the Locus of Control of Behaviour Questionnaire and the Thai HIV Counsellors Survey (THCS). Study 4 involved the development, delivery and evaluation of a series of short courses designed to train 79 health workers to provide HIV counselling. The training was evaluated by pre and post knowledge examinations and anonymous evaluations. Results: Study 1 found that policy and legislation failed to adequately guide the practitioner in a number of key areas including: testing and counselling of minors; testing without informed consent; confidentiality of medical records and disclosure of HIV status; and “duty of care” in terms of threatened suicide or harm to others. Furthermore, it was found that epidemiological data had not been adequately considered in terms of providing specific psychological support services, and developing counselling curriculum, and that the conduct of Thai based psychological and operations research had been limited. Whilst there was good national coverage of HIV testing counselling services, psychological services to address HIV issues across the disease continuum were limited and frequently provided by individuals without adequate training. There does not appear to be any systematic mechanism for monitoring and evaluating HIV mental health and psychosocial care. This study also revealed that Thailand is limited in its ability to provide adequate HIV field-experienced, trained mental health care personnel who can teach in the necessary languages that would enable sharing of the Thai health sector experience within the region. Study 2: The respondents identified a number of workplace stressors including: fear of contagion; client-professional boundary issues; difficulties with being identified as working in the sphere of a highly stigmatised disease; the experience of multiple losses, in a context of perceived inadequate training; role expansion; and perceived lack of recognition and reward. Participants also identified a number of work and socio-cultural influences which were perceived to mitigate the impact of the work. Study 3: Failure to take up counselling duties after training was primarily associated with counsellors having too many competing non-counselling duties (31.2%; n=108), and being deployed to other workplaces in a non-counselling capacity (22.8%,n=79). Over 81% (n=441) of respondents who indicated that they were continuing to work as counsellors reported signs and symptoms of psychological disturbance on the GHQ-28 screening at a level that warranted further mental health assessment. There was a significant positive correlation between GHQ-28 “caseness” and Locus of Control of Behaviour scores (r =.118; p<.001). Decisions to leave counselling were positively associated with self reported psychological disturbance (r =.324; p<.001) and the perception that their work was not helpful to clients (r =.108; p<.001). Study 4: The results clearly showed that the curriculum, and method of training resulted in both perceived and measured change in knowledge and skills and were reported to have resulted in improvements in the trainees’ perceived self confidence to meet the demands of their clients. Conclusion: The studies identified the many challenges inherent in providing effective HIV counselling, mental health and psychosocial services in Thailand. This research suggests that delivering HIV psychosocial care services in Thailand has potentially an adverse impact on: the health and well being of care providers; the quality of care received by clients and patients; and ultimately on the ability of the health system to retain its skilled personnel.
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Klunklin, Areewan, University of Western Sydney, College of Social and Health Sciences, and of Nursing Family and Community Health School. "Thai women's experiences of HIV/AIDS in the rural north : a grounded theory study." THESIS_CSHS_NFC_Klunklin_A.xml, 2001. http://handle.uws.edu.au:8081/1959.7/653.
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Thailand is a nation of some 60 million people, 2 million of whom are estimated to be HIV/AIDS infected and, of those who are infected, 80-90% were infected through heterosexual intercourse and 10-20% are women. In this research, the author discusses the situation in some detail.The experiences of HIV/AIDS infected Thai wives and widows in the rural north of the country are studied.A major contributing factor is the differential constructions of male and female status and sexuality in traditional Thai culture.These constructions are rooted in Theravada Buddhism, ancient mythology and folklore. Data was obtained from 24 participants in Chiangmai Province. The findings of the study revealed several problems with which participants were confronted and the processes they used to address them.It is suggested in the findings that any serious therapeutic interventions and interventionist research studies must be congruent with traditional Thai culture<br>Doctor of Philosophy (PhD)
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Kabir, A. K. M. Humayun Jumroon Mikhanorn. "HIV/AIDS preventive behavior among the housewives of Mae Taeng District in Chiang Mai, Thailand /." Abstract, 2005. http://mulinet3.li.mahidol.ac.th/thesis/2548/cd375/4737939.pdf.
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Kumarawansa, W. K. W. S. Boonyong Keiwkarnka. "Safe sex intention towards HIV/AIDS prevention among secondary school students of Khon Pathom province, Thailand /." Abstract, 2006. http://mulinet3.li.mahidol.ac.th/thesis/2549/cd387/4837998.pdf.
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Morrison, Lynn. "Changing sexual behavior and women's risk for HIV/AIDS in Chiang Mai, Thailand, the fourth wave." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp02/NQ41253.pdf.
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Sharma, Umesh Kumar Boonyong Keiwkarnka. "Study of HIV/AIDS preventive behavior among pregnant women attending antenatal clinic in Ratchvithi hospital, Thailand /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-UmeshS.pdf.
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Jayatilaka, Y. M. C. N. B. Pantyp Ramasoota. "Use of condoms as HIV/AIDS preventive behavior among Sri Lankan adult male visitors in Thailand /." Abstract, 2008. http://mulinet3.li.mahidol.ac.th/thesis/2551/cd414/5038011.pdf.
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Kongsin, Sukhonta. "The economic impact of HIV/AIDS morbidity on households in upper-north Thailand : Phayao case study." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2003. http://researchonline.lshtm.ac.uk/4649781/.
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Background objectives: Previous research has documented the substantial household economic impact of a recent HIV/AIDS death. There is limited information about the household economic impact of HIV/AIDS illness or forms of coping strategies used by households with different levels of available care and support services. The study aimed to understand the economic impact of chronic adult HIV morbidity and examine how households cope with the situation. Specifically the study aimed to: 1) explore the coping strategies used by households to reduce the impact of chronic HIV/AIDS, 2) document the levels and forms of utilisation of support and health services by households affected by chronic HIV/AIDS, 3) explore whether the availability of services influences the household economic impact of chronic HIV/AIDS morbidity, and the coping strategies used by households, 4) explore the implications of the findings for policies to mitigate the impact of HIV/AIDS on households and communities. Study design and setting: The study was conducted in Phayao province in Northern Thailand where people of this province were highly affected by HIV illness and death. Two study districts were identified: Mueng had active support services and Pong had less active services. Within each district, 9 villages were randomly selected and within each village a mapping survey of all households was conducted to identify 'case household' (household with chronically ill adult (CIA)) and 'control household' (household where there was no history of chronic illness in the past 6 months or household member aged 15-49 years died from chronic diseases). In each district, 150 case and 150 control households were selected for interview conducted by trained interviewers in Thai. Outcome indicators: The main outcome indicators were: the reported availability and use of support services, medical care expenditure in the past six months, source and level of income, coping mechanism of households e.g. saving and borrowing money, selling of assets and transfer money. The main outcome indicators compared among case households between two districts were the direct and indirect costs associated with having CIAs, the reported loss of income and how care of children and the elderly was affected by chronic illness. Data entry and analysis: The data were entered twice and cleaned before the final analysis was conducted. Descriptive statistics were used to obtain the demographic and household socio-economic profile and estimates of the socio-economic impact. Tabulations, t-test, bivariate and regression analyses were used to identify factors associated with impact and the coping mechanisms of households. Results: The case and control samples were relatively comparable. Support services in the last six months were more available in Mueng than in Pong in either case or control households. Regression results suggest that having a CIA significantly reduced the reported use of all services. A significantly lower percentage of household members aged 15-59 years were employed in case households than in control households in both districts. Case households as well as households in Mueng were less likely to have cash income and among households with a cash income HIV/AIDS morbidity did not impact on the per capita household cash income and this was confirmed from the regression analysis. About one-third of all households reported having savings. Two-thirds of case households in Mueng and half of case households in Pong reported using their savings for health care cost. Case households in both districts had a lower value of assets per capita than control households. About half of all households reported being in debt. Case households reported being in debt less than control households. Case households borrowed for daily consumption and health care while control households borrowed for investment. To cope with HIV illness, case households used their savings, sold their assets, cut their consumption and obtained transfer-in and supports from extended family members for care for children and the elderly. Various strategies were used to maintain family productivity including increasing family members' workload, hiring labours and withdrawal of children (especially girls) from school. The study documented 324 CIAs from 300 case households. Caregivers who took care of CIAs at home were parents, spouses or children of the CIA, with over a quarter of the adult care-givers stopping working and almost three quarters of child caregivers stopping going to school. In the past 6 months, the average health care expenditure in case households was significantly higher than in control households in both districts and the case households in Mueng reported significantly lower health care expenditure than in Pong. The percentage of case households in Mueng that paid health care expenditure by households was half of that in Pong. This was supported by the proportion of health care card usage among the case households in Mueng which was significantly higher than those in Pong. There were 24% and 39% of case households in Mueng and in Pong reported having experienced being discrimination against. Conclusions: This thesis highlights how chronic HIV morbidity impacts on household income, savings and assets. The study has illustrated how chronic HIV/AIDS morbidity impacts substantially on household labour supply and family production. This impact in case households was relatively more than in control households. Our findings suggest that the Free Medical Program for the poor under the Ministry of Public Health did not reach the poorest section of the case households in Pong. It is important that methods to increase coverage to these vulnerable groups are identified. Case households in Mueng appeared to be less affected by consumption reduction than case households in Pong. This might be because the case households in Mueng had, on average, higher incomes, higher value of assets, lower medical care cost and lower income loss than those of case households in Pong. Our study therefore confirms that the poor families with chronic HIV/AIDS morbidity suffer more consumption reduction. The study has important policy implications to ensure that households can support themselves and meet their medical care needs without jeopardising the wellbeing and future of other household members.
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Ruanjahn, Ganigah. "Improving adherence to highly active anti-retroviral therapy (HAART) among people living with HIV/AIDS in northern Thailand." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2007. https://ro.ecu.edu.au/theses/319.
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Background: This study explored the experiences of people living with HIV/AIDS (PLWHA) in a region of Northern Thailand and Key Informants (Kls). The principal aim of the study was to gain an in-depth understanding of the factors contributing to non-adherence in patients taking Highly Active Anti-Retroviral Therapy (HAART). The data from both PL WHA and Kls were integrated and. analysed to provide an intervention programs aimed at improving adherence in patients commencing HAART. The study itself was divided into three Phases: Phase One was an in-depth exploration of the barriers and ways of improving adherence, Phase Two comprised a series of interventions aimed at patients starting HAART for the first time and Phase Three evaluated the effectiveness of these interventions. Study Population: The study population in Phase One comprised a cohort of 32 HIV infected patients who were over 18 years old and had taken HAART for at least 6 months. Another cohort was comprised 21 Kls who had experience working with HIV care and patients taking HAART. In Phase Two, the population comprised 22 HIV infected patients who were commencing HAART for the first time. After 3 months these same participants were reinterviewed for Phase Three of the study to assess the effectiveness and acceptability of the interventions. Methods: Both qualitative and quantitative data collection methods were used in the study. The qualitative component used a multiple case study approach to explore and describe the experiences of patients receiving HAART. The study was strengthened by the inclusion of in-depth interviews with Kls with extensive knowledge and experience with HIV/AIDS and HAART programs. The quantitative component comprised a demographic survey of both the patients and Kls. This demographic data was used to provide descriptive statistics of the research population and assist with the interpretation of the qualitative data. Results: The findings from Phase One identified a number of interventions that could realistically be implemented to improve medication adherence on patients commencing HAART for the first time. The Phase Three findings showed there were improvements in the patient's adherence to HAAR T during the 3 months of implementing the interventions. The study identified a number of recommendations that Health Care Providers (HCPs) and policy makers could implement to improve medication adherence rates in patients taking HAAR T. The recommendations also included suggestions for future research, Conclusion: The financial and social burden of PL WHA presents an urgent challenge to policy-makers and Health Care Providers to identify sensitive and cost effective management strategies to support such patients and their families. One of the most crucial challenges is to develop interventions that enable patients to gain optimum benefit from the new advances in HIV treatment. A key factor in optimising the benefits of HIV treatment is improving adherence to treatment. The findings from the present study outline a number of interventions that can be cost effectively implemented to improve adherence to HAART and the quality of life of people living with HIV/AIDS.
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Chhetry, Pipal Bahadur Somjai Pramanpol. "Safe sex intention to prevent STD/HIV/AIDS among high school students of Nakhon Pathom province, Thailand /." Abstract, 2000. http://mulinet3.li.mahidol.ac.th/thesis/2551/cd414/5037993.pdf.
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Arenth, Jutta Boonyong Keiwkarnka. "Safe sex intention for HIV/AIDS prevention among male vocational students in selected school Nakhonpathom province, Thailand /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-JuttaA.pdf.
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Kyaw, Soe Nyunt Boonyong Keiwkarnka. "Safe sex behavior towards HIV/AIDS among Myanmar reproductive aged migrants in Muang district, Samutsakhon province, Thailand /." Abstract, 2008. http://mulinet3.li.mahidol.ac.th/thesis/2551/cd414/5038029.pdf.
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Donkaewbua, Siriporn. "Empowering women's self-care : a participatory approach to prevent HIV/AIDS for women and children in Northeast Thailand." Thesis, Robert Gordon University, 2005. http://hdl.handle.net/10059/636.
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Across Thailand there has been a general reduction in the incidence rate of HIV infection in all but one special population group: married women and their offspring whilst the incidence rate is relatively low (1.2%) it has remained steady for a number of years. This participatory approach aims to understand the married women's points of view and to facilitate their self-care to prevent HIV/AIIDS for themselves and their next child. The research utilised a three phase design: exploratory, explanatory and intervention phases. The findings from the first two phases have substantively informed the construction of the intervention phase. The overall findings of the research indicated that women have general knowledge about HIV/AlIDS and carried out general self-care practices. Specific self-care practices however were lacking. Through the participatory intervention phase the research has been able to illuminate a number of important factors pertaining to women's self-care most-noticeably: the importance of support; the strategies women adopt to balance health and social risk; the importance of consciousness raising; and the need for culturally sensitive health care programmes. The research concludes by presenting an analytical model of women's self-care for the prevention of HIV/AIDS and makes a series of recommendations with regard to the development of existing Thai health care services, the enhancement of the current educational curricula, and the incorporation of participatory approaches in health promotion and health care provision for families.
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Ngamvithayapong-Yanai, Jintana. "Challenges and opportunities for tuberculosis prevention and care in an HIV epidemic area, Chiang Rai, Thailand /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-440-2/.
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Kharel, Ramesh Kumar Boonyong Keiwkarnka. "Participation of village health volunteers on HIV/AIDS prevention and control programme in Wattana-Nakhorn district, Sakaeo province, Thailand /." Abstract, 2006. http://mulinet3.li.mahidol.ac.th/thesis/2549/cd387/4837995.pdf.
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Paul, Godfred. "When the boomerang returns : a qualitative study of the socio-economic impacts of HIV/AIDS on older people in Northern Thailand /." St. Lucia, Qld, 2003. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17500.pdf.
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Pardthaisong-Chaipanich, Liwa. "The developmental implications of rapid demographic change : fertility decline, net out-migration and HIV/AIDS interactions in rural northern Thailand." Thesis, University of Dundee, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.430195.
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Klunklin, Areewan. "Thai women's experiences of HIV/AIDS in the rural north : a grounded theory study." Thesis, View thesis, 2001. http://handle.uws.edu.au:8081/1959.7/653.
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Thailand is a nation of some 60 million people, 2 million of whom are estimated to be HIV/AIDS infected and, of those who are infected, 80-90% were infected through heterosexual intercourse and 10-20% are women. In this research, the author discusses the situation in some detail.The experiences of HIV/AIDS infected Thai wives and widows in the rural north of the country are studied.A major contributing factor is the differential constructions of male and female status and sexuality in traditional Thai culture.These constructions are rooted in Theravada Buddhism, ancient mythology and folklore. Data was obtained from 24 participants in Chiangmai Province. The findings of the study revealed several problems with which participants were confronted and the processes they used to address them.It is suggested in the findings that any serious therapeutic interventions and interventionist research studies must be congruent with traditional Thai culture
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Benjakul, Wunvimul. "The assessment of HIV knowledge and attitudes towards caring for HIV/AIDS patients among senior nursing students in baccalaureate programs in the United States of America and Thailand." Diss., Columbia, Mo. : University of Missouri-Columbia, 2006. http://hdl.handle.net/10355/4386.
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Thesis (Ph. D.)--University of Missouri-Columbia, 2006.<br>"December 2006" The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Vita. Includes bibliographical references.
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Naoi, Riyo. "Documentary Film Production on the Dynamics of Relationship regarding HIV in Northern Thailand: A Filmmaker's Perspective in Representing Reality." 京都大学 (Kyoto University), 2015. http://hdl.handle.net/2433/199426.
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Berry, Scott D. "Community of blood : impacts and management of intersecting stigmas among Thai same-sex attracted men and transgender people with HIV." Thesis, Queensland University of Technology, 2017. https://eprints.qut.edu.au/103669/1/Scott_Berry_Thesis.pdf.
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This study presents findings of research undertaken with 22 same-sex-attracted men and transgender people living with HIV (PLHIV) in community or self-help groups in Thailand. It examines experiences of stigma associated with same-sex attraction, non-binary gender identity and HIV. It investigates the ways that intersecting stigma associated with sex, gender and HIV affected the study participants’ lives and influenced their decisions to join and remain in community groups of same-sex-attracted and transgender PLHIV. The project adopted grounded theory, a qualitative research method, to undertake fieldwork between 2012 and 2014. The research contributes to scholarship on HIV stigma and its management. The individuals living with HIV in this study felt generally powerless to change HIV stigma and its multiple impacts on their own. However, together they found they had more power and more capacity to change the Thai stigma associated with HIV.
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Versteynen, Leo. "Improvement of global access to life-saving medicines : facing the future." Thesis, University of Bradford, 2010. http://hdl.handle.net/10454/5328.
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This research, with the main focus on HIV/AIDS, tuberculosis and malaria, was based on data from the literature, and on questionnaire and interview surveys with the main stakeholders: authorities, drug-developers and NGOs/foundations. It revealed the following determinants, which contributed to the occurrence of drug pricing conflicts in Brazil, Thailand and South Africa: governmental constitutional commitments to supply medicines to poor people, the existence of a local pharmaceutical industry capable of producing generic versions of patented medicines and long histories of disease treatment programmes. The research documented the preferred approaches to increase global access to life-saving medicines for the next decade, which were found to be: public-private-partnerships, prevention measures, dedication of >0.5% of GNP to poor countries, and improvement of national healthcare/insurance systems. Those approaches were integrated into a conceptual framework, which could enable country-level organizations to move beyond the conflict mentality via a 'Public-Private-Partnership for gradual Self-Sufficiency and Sustainability Model,' (P3S3). Within this framework, rich countries should invest >0.5% of their GNP to help to alleviate poverty in poor countries. With these funds, national governments should implement programmes to expand implementation of disease prevention measures and improve national - 4 - healthcare/insurance systems and the quality of the medicines involved. Public-private-partnerships should act as 'steering-and-controlling' organizations to guide the process and to minimise corruption. As a positive message to all who currently lack access to these medicines, the thesis author's conclusion is that the use of this model could help to turn the current unsustainable development policies into sustainable ones, and as a consequence, it would contribute to improvements in the quality of life of millions of people in poor countries.
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Ruppert-Mann, Gesine. "Villagers in northeast Thailand and AIDS /." Title page, table of contents and summary only, 1994. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmr946.pdf.
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Павличева, Світлана Володимирівна, Светлана Владимировна Павлычева, Svitlana Volodymyrivna Pavlycheva, and U. Anyanwu. "HIV/AIDS in Ukraine." Thesis, Видавництво СумДУ, 2011. http://essuir.sumdu.edu.ua/handle/123456789/15953.
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Ukraine has one of the fastest growing HIV/AIDS epidemics in the world. Experts estimated in August 2010 that 1.3 percent of the adult population of Ukraine was infected with HIV, the highest in all of Europe. Although HIV/AIDS has to date remained concentrated among marginalized and vulnerable populations, it may be spreading to the general population. The majority of those infected are under 30 years of age; a full 25% of those affected are still in their teens.
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Melo, Angela Margarida Matos de Souza. "Maternidade e HIV/AIDS." reponame:Repositório Institucional da UFSC, 2013. https://repositorio.ufsc.br/handle/123456789/107180.
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Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Filosofia e Ciências Humanas. Programa de Pós-Graduação em Psicologia, Florianópolis, 2013<br>Made available in DSpace on 2013-12-05T23:26:08Z (GMT). No. of bitstreams: 1
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Previous issue date: 2013<br>Esta dissertação procurou estabelecer, a partir da teoria e escuta psicanalíticas, relações entre as vivências simultâneas da maternidade e da infecção pelo HIV, em mulheres atendidas em ambulatório especializado no tratamento e prevenção do HIV/Aids, que tiveram o diagnóstico durante a gestação ou até o terceiro mês de vida do bebê. Tanto a maternidade como a doença são construções histórico-culturais, com valorações antagônicas e associadas a representações socialmente compartilhadas, produzindo efeitos de subjetivação. Enquanto que a maternidade é associada à transmissão da vida e a um ideal de amor e doação, conferindo maior valoração à mulher que se torna mãe, o vírus HIV e a Aids são associados ao adoecimento e à morte. Pessoas infectadas pelo HIV, especialmente mulheres, são consideradas promíscuas e estigmatizadas, existindo a fantasia de que mulheres que têm relações estáveis estão a salvo da infecção. No Ocidente, sob a influência de diversos saberes e do cristianismo, foi estabelecida uma dicotomia entre a maternidade e o erotismo. Assim, se a sexualidade era legitimada nos homens, a sua expressão nas mulheres era vista como sinal de desvio de conduta, visão que ainda hoje produz efeitos nas práticas e valores morais compartilhados socialmente. Freud, ao atribuir à sexualidade um lugar central na constituição do sujeito, associada aos desejos inconscientes e voltada essencialmente à obtenção de prazer, dá-lhe outro estatuto, desvinculando-a da finalidade reprodutiva, ao mesmo tempo em que restitui à mulher seu corpo erotizado. Apesar dos esforços das instituições sociais para conter a sexualidade por meio de normas, ela extravasa os limites estabelecidos. A busca de prazer coloca as mulheres em condição de maior vulnerabilidade, em decorrência das assimetrias, culturalmente justificadas e validadas, nas relações de gênero. Essa assimetria coloca grande parte das mulheres em uma posição de submissão frente ao homem, o que se evidenciou nas falas das mulheres atendidas no ambulatório. Para muitas pessoas, ainda prevalece a visão dicotômica entre a mulher recatada e a que vivencia sua sexualidade livremente. As mulheres que contraem o vírus através da prática sexual, sem que tenham uma relação estável, são desqualificadas, enquanto que aquelas que foram infectadas pelos maridos, são vistas como vítimas de uma fatalidade. Assim, grande parte das mulheres atendidas, infectadas pelo vírus, temia que sua condição fosse descoberta e relutava em contar ao companheiro sobre essa condição. Tinham medo de serem abandonadas, receavam não mais poder dar expressão à sua sexualidade e muitas delas, em suas fantasias, temiam sofrer violência física. Além desses receios, comuns a outras mulheres, as gestantes expressavam medo de transmitir o vírus ao filho, o que as fazia viver um conflito, e muitas achavam que não poderiam ser boas mães, uma vez que não poderiam amamentar. Assujeitadas aos valores vigentes, elas próprias sentiam-se destituídas de valor. Propiciar a essas mulheres um espaço de fala e escuta, possibilitou a muitas delas a oportunidade de re-elaboração subjetiva de fantasias relacionadas à condição de soropositivas, proporcionando-lhes a busca de novas formas de lidar com a realidade e com o outro. <br><br>Abstract: This dissertation has tried to establish, from theory and psychoanalytic sessions, the relations between the simultaneous experiences of maternity and HIV infection in women attended in an ambulatory specialized in HIV/Aids treatment and prevention, who were diagnosed during pregnancy or within three months of their babies? lives. Both maternity and disease are historical and cultural constructions with antagonistic valuation and associated to socially shared representations, producing subjective effects. While maternity is associated to the transmission of life and to an ideal of love and donation, conferring a greater value to a woman who becomes a mother, the HIV virus and Aids are associated to illness and death. HIV infected persons, specially women, are considered promiscuous and are stigmatized, existing the fantasy that women who have stable relationships are safe from infection. In the West, under the influence of various sciences and of Christianism, a dichotomy has been established between maternity and eroticism. As a result, if sexuality were legitimate for men, its expression in women was seen as a signal of a conduct deviation, a vision that still produces effects nowadays in socially shared practices and moral values. When Freud assigned to sexuality a central place in a subject?s constitution, associated to unconscious desires and essentially connected to obtaining pleasure, he gave it another dimension, disconnecting it from reproductive purposes, at the same time returning to women their eroticized bodies. Regardless of the efforts made by social institutions to contain sexuality by means of rules it goes beyond established limits. The search of pleasure places women in a more vulnerable condition as a result from culturally justified and validated asymmetries in gender relations. Such asymmetry puts an important part of women in a position of submission before men, which has been evidenced in the spoken reports of women attended in the ambulatory. Many persons still have a dichotomic vision between the modest woman and that who freely lives her sexuality. Women who are infected by the virus through sexual intercourse without having a stable relationship are disqualified, while those who have been infected by their husbands are seen as victims of a fatality. Thus, a great number of women attended, infected by the virus, feared the disclosure of their condition and were reluctant in telling their companions about their condition. They were afraid of being left, feared no longer being able to express their sexuality and, many of them, in their fantasies, were afraid of physical violence. Besides such fears, common to other women, pregnant women expressed fear of transmitting the virus to their babies, leading them to a conflict, and many thought they could not be good mothers since they would not be able to breast-feed. Submitted to the current values, they themselves felt valueless. By giving these women a space to speak and to being heard, many of them had the opportunity to subjectively re-make their fantasies related to their serum-positive condition and to search new ways to deal with reality and with others.
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Ståhl, Martinsson Malin, and Linda Ingemarsson. "Arbetsterapi för personer med HIV/AIDS : Occupational therapy for persons with HIV/AIDS." Thesis, Örebro University, Department of Health Sciences, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-747.
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<p>Bakgrund: Varje dag smittas i genomsnitt cirka 14 000 personer av HIV i världen. Ny behandling har gjort att dessa patienter idag lever längre. Sjukdomsförlopp samt komplikationer går inte att förutsäga utan är individuellt. Eftersom personer med HIV/AIDS-diagnos nu lever längre kommer behovet av arbetsterapeutiska insatser att öka. Syfte: Syftet med studien är att beskriva arbetsterapeutiska insatser för personer med HIV/AIDS samt vilken roll arbetsterapeuten har i arbetet kring dessa personer. Metod: En systematisk litteraturstudie gjordes för att få svar på syftet. Resultat: Vi har kommit fram till att arbetsterapeutiska insatser för personer med HIV/AIDS kan delas in i fem teman; Handledning, Hjälpmedel och anpassning, Undervisning, Förhållningssätt samt Existentiella frågor och andlighet. Arbetsterapeuten hjälper patienten att formulera målsättningar och att uppnå ökad självständighet genom att bland annat tillhandahålla hjälpmedel och bedriva utbildning. HIV/AIDS-patienters bakgrund är viktig att tänka på då den kan visa hur mottaglig en patient är för olika arbetsterapeutiska behandlingsmetoder. Slutsats: Arbetsterapeutiska insatser som används i arbetet med HIV/AIDS-patienter skiljer sig inte mot insatser riktade till andra patientgrupper.</p>
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Sulprizio, G. "ICT4D & HIV/AIDS: an exploration of mHealth for HIV/AIDS in South Africa." Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/3850.
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Oliveira, Fernanda Cristina Leite de. "Transmissão materno-infantil HIV/AIDS." reponame:Repositório Institucional da UFPR, 2013. http://hdl.handle.net/1884/29337.
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Resumo: Esta pesquisa, financiada pela bolsa de mestrado CAPES/REUNI, é um estudo sobre as relações entre mães e filhos quando há a transmissão vertical do vírus HIV. Em pesquisa anterior verificou-se que quando a mulher se descobre soropositiva ela busca a reconstrução de si, sobretudo a partir de um filho ou marido. É justamente a relação com esse filho, também portador do vírus, cuja contaminação ocorreu através da transmissão maternoinfantil, que exploramos agora. Entender o que houve para que essa transmissão não tenha sido evitada foi um dos objetivos principais desta pesquisa. Trabalhamos com estudo de casos, sendo assim, entrevistamos 5 mulheres soropositivas que tinham filhos (as) também soropositivos (as), sendo que 4 destas filhas também foram entrevistadas. Os locais onde encontramos essas pessoas, nas condições necessárias para a pesquisa, foram os ambulatórios de infectologia adultos e os grupos de adesão também dos adultos, ambos do Hospital de Clínicas de Curitiba. E para isso tivemos que passar pelo Comitê de Ética em Pesquisa em Seres Humanos do hospital, com o projeto aprovado em 27 de setembro de 2010, com registro no CEP número 2269.163/2010-07, de acordo com a Resolução 196/96 e suas complementares sobre Diretrizes e Normas Regulamentadoras de Pesquisa Envolvendo Seres Humanos do Ministério da Saúde.
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Zhang, Xinjian. "HIV/AIDS relative survival analysis." unrestricted, 2007. http://etd.gsu.edu/theses/available/etd-07262007-123251/.
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Thesis (M.S.)--Georgia State University, 2007.<br>Title from file title page. Gengsheng (Jeff) Qin, committee chair; Ruiguang (Rick) Song, Xu Zhang, Yu-Sheng Hsu, committee members. Electronic text (79 p. : col. ill.) : digital, PDF file. Description based on contents viewed Sept. 16, 2008. Includes bibliographical references (p. 38-42).
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Finkler, Lirene. "HIV/AIDS e relacionamentos conjugais." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2003. http://hdl.handle.net/10183/4157.
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Dificuldades na prevenção do HIV/AIDS em relacionamentos heterossexuais estáveis recomendam estudos deslocando o foco do individual para o interacional. Entrevistou-se 15 casais heterossexuais, que realizaram conjuntamente testagem voluntária em serviço de saúde pública. Foram realizados dois estudos: o Estudo 1 explora aspectos da motivação para a realização da testagem sorológica, conhecimentos sobre HIV/AIDS e susceptibilidade percebida; o Estudo 2 descreve e analisa práticas preventivas adotadas nos períodos anterior e posterior à testagem para HIV. Os dados foram analisados através de procedimentos qualitativo-fenomenológicos: descrição qualitativa, análise indutiva ou temática e análise crítica ou interpretação. Os resultados indicam que padrões relacionais entre gêneros e dificuldade na relação conjugal influenciam a vivência da suscetibilidade de infecção e a adoção de práticas preventivas. Os riscos de infecção são negados ou desvalorizados, mesmo em casais sorodiscordantes, por dificuldades com o tema sexualidade e por padrões de comportamento de gênero: homens expõem-se a risco para afirmar sua masculinidade; mulheres para manter relacionamentos afetivos. Implicações para prevenção são discutidas, destacando a importância do desenvolvimento de intervenções com ambos os cônjuges que levem em conta dinâmicas dos relacionamentos e formas de comunicação necessárias para construção e manutenção de comportamentos preventivos.
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Saunders, Jane Noreen. "Neuropsychiatric features of HIV/AIDS." Doctoral thesis, University of Cape Town, 2006. http://hdl.handle.net/11427/11107.
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Includes bibliographical references (p. 197-229).<br>The central hypothesis of this thesis was that HIV psychosis and mania are overlapping manifestations of the neuropathophysiological consequences of HIV characterized by symptoms suggestive of sub-acute delirium and cognitive impairment. It was also hypothesised that HIV-associated mania and psychosis are AIDS-defining features and should be indications for antiretroviral treatment.
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Nnajiofor, Chinyere Fidelia. "HIV/AIDS-Related Stigma and Discrimination Toward Women Living With HIV/AIDS in Enugu, Nigeria." Thesis, Walden University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10143549.
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<p> HIV/AIDS-related stigma and discrimination (S&D), lack of social support, poverty, and gender inequalities have been identified as factors in the increased prevalence rate of HIV transmission in Enugu, Nigeria, especially among women ages 15 to 49 years. Despite the funding of reduction programs, HIV/AIDS-related S&D remain a major driving force in the increased rate of new HIV cases in Enugu. This study addressed a perceived need for behavioral change intervention approaches that span all societal factors to reduce the HIV infection rate in Enugu Nigeria. The study was guided by Goffman’s (1963) social S&D theory. The sample was composed of 132 women living with HIV/AIDS WLWHA ages 21 to 54 years, purposefully sampled from the 4 HIV and AIDS comprehensive initiatives care centers in Enugu, Nigeria. Fifteen WLWHA were interviewed and 114 participated in an online survey. The descriptive statistics and a multiple linear regression analysis and comparison revealed a convergent significant relationship between the S&D determinants (social, political, psychological, environmental, and cultural) and HIV/AIDS-related S&D towards WLWHA in Enugu F (4,109) = 45.09, p <.001). It also revealed that the cultural determinant of S&D was a significant predictor of HIV/AIDS-related S&D towards WLWHA in Enugu (? = 0.81, p < 0.001). The implications for positive social change include providing public health professionals evidence-based data to inform policy change, plan and to implement programs that will change societal attitudes and mobilize broad-based community actions to eradicate HIV/AIDS–related S&D toward WLWHA in Enugu, Nigeria, and in Sub-Saharan African Countries.</p>
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Mlobeli, Regina. "HIV/AIDS Stigma: an investigation into the perspectives and expereinces of people living with HIV/AIDS." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_6069_1189595852.
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<p>People's attitudes towards people living with HIV/AIDS remain a major community challenge. There is a need to generate a climate of understanding, compassion and dignity in which people living with HIV/AIDS (PLWHA) will be able to voluntarily disclose their status and receive the support and respect all people deserve. However, many people expereince discrimination because they have HIV/AIDS. In a certain area in Khayelitsha, a township in Cape Town, a young woman was killed after disclosing the HIV status after being raped by five men. While many previous studies have focused on the external stigma in the general population, there is a dearth of studies on stigma among PLWHA themselves and hence the aim of the present study was to investigate stigma attached to HIV/AIDS from the perspective of PLWHA.</p>
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Fagerberg, Ebba. "HIV/AIDS-politik i Sydafrika : En innehållsanalys av de tre nationella strategiska planerna för HIV/AIDS." Thesis, Linnéuniversitetet, Institutionen för samhällsvetenskaper, SV, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-19885.
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Cardey, Sarah. "Integrated approaches to HIV/AIDS communication : Taking a vulnerability perspective towards HIV/AIDS in development communications." Thesis, University of Reading, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.529975.
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Cullen, Christine. "Understanding misperceptions about HIV and AIDS." Diss., Connect to the thesis, 2006. http://thesis.haverford.edu/154/01/2006CullenCEconomics.pdf.
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Baricca, Ana Maria. "Vivendo e crescento com HIV/Aids." Sao Paulo : [s.n.], 2005. http://10.188.1.43/lildbi/docsonline/0/3/130-Tese%5FCCD%5FBaricca,%5FAna%5FMaria%5F2005.PDF.
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Roberts, Marguerite. "HIV/AIDS in the lesbian community." Connect to resource, 2007. http://hdl.handle.net/1811/28391.
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Thesis (Honors)--Ohio State University, 2007.<br>Title from first page of PDF file. Document formatted into pages: contains 24 p. Includes bibliographical references (p. 22-24). Available online via Ohio State University's Knowledge Bank.
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Services, School of Native Human. ""HIV/AIDS: Issues within Aboriginal Populations"." School of Native Human Services, 2003. http://142.51.24.159/dspace/handle/10219/439.
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Eze, Jude Ikechukwu. "Modelling HIV/AIDS epidemic in Nigeria." Thesis, University of Glasgow, 2009. http://theses.gla.ac.uk/642/.
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Nigeria is one of the countries most affected by the HIV/AIDS pandemic, third only to India and South Africa. With about 10% of the global HIV/AIDS cases estimated to be in the country, the public health and socio-economic implications are enormous. This thesis has two broad aims: the first is to develop statistical models which adequately describe the spatial distribution of the Nigerian HIV/AIDS epidemic and its associated ecological risk factors; the second, to develop models that could reconstruct the HIV incidence curve, obtain an estimate of the hidden HIV/AIDS population and a short term projection for AIDS incidence and a measure of precision of the estimates. To achieve these objectives, we first examined data from various sources and selected three sets of data based on national coverage and minimal reporting delay. The data sets are the outcome of the National HIV/AIDS Sentinel Surveillance Survey conducted in 1999, 2001, 2003 and 2005 by the Federal Ministry of Health; the outcome of the survey of 1057 health and laboratory facilities conducted by the Nigerian Institute of Medical Research in 2000; and case by case HIV screening data collected from an HIV/AIDS centre of excellence. A thorough review of methods used by WHO/UNAIDS to produce estimates of the Nigerian HIV/AIDS scenario was carried out. The Estimation and Projection Package (EPP) currently being used for modelling the epidemic partitions the population into at-risk, not-at-risk and infected sub-populations. It also requires some parameter input representing the force of infection and behaviour or high risk adjustment parameter. It may be difficult to precisely ascertain the size of these population groups and parameters in countries as large and diverse as Nigeria. Also, the accuracy of vital rates used in the EPP and Spectrum program is doubtful. Literature on ordinary back-calculation, nonparametric back-calculation, and modified back-calculation methods was reviewed in detail. Also, an indepth review of disease mapping techniques including multilevel models and geostatistical methods was conducted. The existence of spatial clusters was investigated using cluster analysis and some measure of spatial autocorrelation (Moran I and Geary c coefficients, semivariogram and kriging) applied to the National HIV/AIDS Surveillance data. Results revealed the existence of spatial clusters with significant positive spatial autocorrelation coefficients that tended to get stronger as the epidemic developed through time. GAM and local regression fit on the data revealed spatial trends on the north-south and east - west axis. Analysis of hierarchical, spatial and ecological factor effects on the geographical variation of HIV prevalence using variance component and spatial multilevel models was performed using restricted maximum likelihood implemented in R and empirical and full Bayesian methods in WinBUGS. Results confirmed significant spatial effects and some ecological factors were significant in explaining the variation. Also, variation due to various levels of aggregation was prominent. Estimates of cumulative HIV infection in Nigeria were obtained from both parametric and nonparametric back-calculation methods. Step and spline functions were assumed for the HIV infection curve in the parametric case. Parameter estimates obtained using 3-step and 4-step models were similar but the standard errors of these parameters were higher in the 4-step model. Estimates obtained using linear, quadratic, cubic and natural splines differed and also depended on the number and positions of the knots. Cumulative HIV infection estimates obtained using the step function models were comparable with those obtained using nonparametric back-calculation methods. Estimates from nonparametric back-calculation were obtained using the EMS algorithm. The modified nonparametric back-calculation method makes use of HIV data instead of the AIDS incidence data that are used in parametric and ordinary nonparametric back-calculation methods. In this approach, the hazard of undergoing HIV test is different for routine and symptom-related tests. The constant hazard of routine testing and the proportionality coefficient of symptom-related tests were estimated from the data and incorporated into the HIV induction distribution function. Estimates of HIV prevalence differ widely (about three times higher) from those obtained using parametric and ordinary nonparametric back-calculation methods. Nonparametric bootstrap procedure was used to obtain point-wise confidence interval and the uncertainty in estimating or predicting precisely the most recent incidence of AIDS or HIV infection was noticeable in the models but greater when AIDS data was used in the back-projection model. Analysis of case by case HIV screening data indicate that of 33349 patients who attended the HIV laboratory of a centre of excellence for the treatment of HIV/AIDS between October 2000 and August 2006, 7646 (23%) were HIV positive with females constituting about 61% of the positive cases. The bulk of infection was found in patients aged 15-49 years, about 86 percent of infected females and 78 percent of males were in this age group. Attendance at the laboratory and the proportion of HIV positive tests witnessed a remarkable increase when screening became free of charge. Logistic regression analysis indicated a 3-way interaction between time period, age and sex. Removing the effect of time by stratifying by time period left 2-way interactions between age and sex. A Correction factor for underreporting was ascertained by studying attendance at the laboratory facility over two time periods defined by the cost of HIV screening. Estimates of HIV prevalence obtained from corrected data using the modified nonparametric back-calculation are comparable with UN estimates obtained by a different method. The Nigerian HIV/AIDS pandemic is made up of multiple epidemics spatially located in different parts of the country with most of them having the potential of being sustained into the future given information on some risk factors. It is hoped that the findings of this research will be a ready tool in the hands of policy makers in the formulation of policy and design of programs to combat the epidemic in the country. Access to data on HIV/AIDS are highly restricted in the country and this hampers more in-depth modelling of the epidemic. Subject to data availability, we recommend that further work be done on the construction of stratification models based on sex, age and the geopolitical zones in order to estimate the infection intensity in each of the population groups. Uncertainties surrounding assumptions of infection intensity and incubation distribution can be minimized using Bayesian methods in back-projection.
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Brailsford, Sally Caroline. "Modelling for HIV infection and AIDS." Thesis, University of Southampton, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.358459.
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Matthew, I. G., and I. C. Sandra. "Prevalence of HIV/AIDS in Nigeria." Thesis, Сумський державний університет, 2013. http://essuir.sumdu.edu.ua/handle/123456789/32301.
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Nigeria has the second highest number of people living with HIV in the world. Since 1986 when the first case of the Acquired Immune Deficiency Syndrome (AIDS) was reported in Nigeria, the disease has grown to epidemic proportions with the prevalence of its causative agent - the Human Immunodeficiency Virus (HIV) being observed to be steadily rising since the early days of the epidemic. Therefore it is important to talk about the prevalence of HIV infection in Nigeria.
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