Global Health and HIV Essay

Pages: 10 (4194 words)  ·  Bibliography Sources: 4  ·  File: .docx  ·  Level: College Senior  ·  Topic: Disease

SAMPLE EXCERPT . . .
The stigmatization of the African-American identity in relation to diseases in the early twentieth century shows a remarkable continuity today in the context of HIV / AIDS at the turn of the century." (p. 1)

Bharat also described that stigma related to AIDS and discrimination is multifaceted social practice. They are neither exclusive and nor arbitrarily patterned. They generally are constructed upon and strengthen pre-existing doubts, chauvinisms and social disparities pertaining to poverty, gender, race, sex and sexuality, and so on. In this way, racist behaviors and racial inequity associated to HIV / AIDS status are only playing into, and reinforcing, previously active racial stereotypes and disparities about people of color in general. "There is a four part process of stigmatization on the part of a society: first, by identifying and defining the disease; second by assigning responsibility for its appearance to some person, group or thing; third, by determining whether those affected by the disease are to be viewed as innocent or guilty; and fourth, by assigning responsibility for identifying a cure or solution to another segment of society." (pp. 4-5)

Impact of HIV / AIDS-Related Stigma on Psychological Distress

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Psychological distress typically refers to the experience of negative affective states, such as depression, anxiety, and loss of emotional and behavioral control (Manning & Wells, 6). In the U.S., several research studies involving PLWHA have documented the association between at least one of the three different dimensions of HIV / AIDS-related stigma (e.g., enacted, perceived, and internalized) and depression, as well as anxiety, alienation, and poor psychological functioning. In addition, previous U.S. empirical studies among PLWHA have found a significant positive relationship between one of the dimensions of HIV / AIDS-related stigma and psychological distress (Silver, Bauman, Camacho, & Hudis, 431).

Essay on Global Health & HIV Global Assignment

In one of the earliest studies on AIDS-related stigmatization, Crandall and Coleman (163) found in sample of 48 U.S. men and women who were either diagnosed with AIDS or AIDS related complex, 2 or were diagnosed as being HIV-positive that those participants who felt stigmatized by others also experienced higher levels of depression, anxiety, and alienation. Moreover, these authors showed that feelings of depression, anxiety, and alienation were independent of HIV diagnostic severity but were associated with disruptions in social relationships. Lichtenstein and colleagues study on chronic sorrow with a diverse sample of 21 HIV-positive men and women living in Birmingham, Alabama showed that half of their participants were clinically depressed. In particular, these authors noted that stigma and the social isolation that results from having a "discredited identity" were especially challenging for the African-American infected mothers in the study, who reported greater levels of depression. Clark (2003) also found that higher perceptions of AIDS-related stigma among their sample of 98 HIV-infected African-American women with children were associated with poorer psychological functioning. These authors operational zed psychological functioning as the extent to which the experience of AIDS-related stigma was perceived to cause psychological distress.

Impact of HIV / AIDS-Related Stigma on Health-Related Quality of Life

Health-related quality of life is a multidimensional construct generally defined as a subjective evaluation of one's life across a number of dimensions including physical functioning, social functioning, pain, and energy (Nordenfelt, 52). Research on adaptation to terminal or chronic illnesses highlight the importance of a number of personal and environmental characteristics that influence health-related quality of life. These characteristics include self-esteem, quality of social and family relationships, role functioning, financial resources, and communication patterns (Servellen & Aguirre, 134).

An increasing number of empirical studies have focused on assessing health-related quality of life among PLWHA (Howland, Storm, Crawford, Ma, Gortmaker, & Oleske, 3). Early investigations of health-related quality of life among PLWHA focused on assessment methodology issues (e.g., Kaplan, Anderson, Wu, Matthews, Kozin, & Orenstein, 43). However, more recent studies have sought to identify predictors of health-related quality of life and to develop interventions by which it can be improved for PLWHA (Hughes, Jelsma, MacLean, Darder, & Tinise, 371).

Orlando, Guaraldi, Murri, Wu, Nardini, Beghetto et al. found a significant negative correlation between lipodystrophy (a disturbance in the way one's body produces, uses, or stores fat) and lower health-related quality of life among 175 AIDS patients living in Italy. Although these investigators did not measure HIV / AIDS-related stigma directly, they reported that lower role functioning as measured by their health-related quality of life scale was attributable to perceived stigma. These unpublished international studies illustrate the need for additional research to investigate the relationship between HIV / AIDS-related stigma and health-related quality of life among PLWHA in the U.S.

Cultural Impacts related to HIV / AIDS

From the research it has been improved that social and cultural factors have great influence on HIV / AIDS patients and it has been suggested to improve the social relationships at family, hospital and office level so as to improve the quality of life of the AIDS affected individuals. Extending the relationship beyond the patient and provider (e.g., doctors, nurses) to improve a patient's health-promoting behaviors (i.e., recommended healthy eating), health care behaviors (i.e., treatment adherence), and health-related outcomes and statuses (i.e., blood pressure), Tucker, Herman, Ferdinand, Bailey, Lopez, Beato, proposed a literature based, testable, and formative model for patient-centered culturally sensitive health care (PCCSHC) that also includes office staff members (e.g., front desk staff) behaviors and physical environmental characteristics (e.g., waiting room area) and policies (e.g., stated and publicly displayed statement regarding the order in which patients are seen) of the health care clinic. In their work, these authors specifically argued for the promotion of PC-CSHC environments with the ultimate goal of reducing the health disparities that currently exist between minority and majority individuals all over the world.

According to Tucker., their model consists of a PC-CSHC intervention program that includes the following three subcomponents: (a) training health care providers and office staff members to engage in behaviors and display attitudes that enable patients to feel comfortable with, trusting of, and respected by their health care providers and staff members and that enable them to feel that they and their cultures are respected (i.e., inquiring about and respecting cultural beliefs of patients); (b) changing the health care clinic physical environment and clinic policies in ways that culturally diverse patients report as making them feel a sense of comfort and belonging in the clinic and involving health care administrators and providers in making these changes (i.e., displaying culturally diverse artwork and informational materials and posting a statement regarding the order in which patients are seen); and (c) training and empowering patients to engage in health-promoting lifestyles and to motivate and inspire desired behaviors and attitudes from providers and office staff members (i.e., giving negative and positive feedback to their health care provider or front desk staff member in a constructive manner) and desired changes in the health care environment (i.e., requesting that an indoor child's play area be created in the clinic waiting area).

It is explained by Tucker et al. that with the implementation of the PC-CSHC intervention program participating patients' levels of perceived PC-CSHC and perceived interpersonal control (e.g., psychological empowerment) are impacted, which in turn, influence patients' engagement in health-promoting behaviors and health care satisfaction. It is also suggested in the PC-CSHC model that patient health care satisfaction directly effects patient treatment adherence; but is not directly associated with patient health outcomes and statuses. Rather, these authors postulated that health outcomes and statuses are influenced separately by patients' health-promoting lifestyles and treatment adherence.

Social Support, HIV / AIDS-Related Stigma, and Psychological Distress

Social support from significant others, family members, and friends is widely believed to buffer the impact of a variety of stressful life events including chronic illness. Decreases in the experience of psychological distress among PLWHA have been linked to social support (Hudson, Lee, Miramontes, & Portillo, 68). In addition, social support is considered to be an important factor in HIV illness progression (Golub, Astemborski, Hoover, Anthony, Vlahov, & Strathdee, 431), adherence to medication regimens (Ammassari, Trotta, Murri, Castelli, Narciso, Noto et al., 127), physical functioning (Vogl, Rosenfeld, Breitbart, Thaler, Passik, McDonald et al., 253), and spirituality (Tuck, McCain, & Elswick, 776).

Recently, it has been suggested that social support may assist in decreasing the experience of HIV / AIDS-related stigma, which in turn, might reduce the experience of psychological distress among PLWHA (Swendeman, Rotheram-Borus, Comulada, Weiss, & Ramos, 501). In previous health-related research, social support has been identified as a moderator of the relationship between stress and health outcomes and stress and depressed mood.

Demographic Characteristics and HIV / AIDS-Related Stigma

Prior research has investigated the relationship between various demographic characteristics (e.g., gender, race, sexual orientation, social class, and age) and HIV / AIDS related stigma. Carr and Gramling (39) and Lekas, Siegel, and Schrimshaw found significant positive associations between gender and HIV / AIDS-related stigma in their community samples of HIV-positive persons living throughout the U.S. In addition, Sandelowski, Lambe, and Barroso conducted a meta-synthesis (systematic… [END OF PREVIEW] . . . READ MORE

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