Scholarly paper on HIV in women
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Introduction Relevant nursing issue Some of the questions that arise from women living with HIV are barrier to social services. It affects the livelihood of women; thus, they are unable to acquire some essential services. Another issue is that they have mental health problem; thus, they are placed at a higher risk for HIV infection. They also face stigmatization that is rooted in discrimination (Peninnah, 2013). Other issues that arise are limitation to children health care, misinformation regarding treatment options, lack of access to transportation, substance abuse in regard to treatment, and unstable housing. There are attempts that have been put to measure and understand one’s health status. The rules also incorporate the physical wellbeing, psychological status, and cognitive functioning (Deanna, 2013). The tests are referred to as Health-related quality of life (HRQoL). It is a way of knowing how individuals feel about their health. It is done from an interactive and interpretive point of view. It enables an empathetic understanding of daily life experience is different life settings. HRQoL also enhances the identification of the different race, gender, class and social positioning. It also considers social cultural and political forces. It has been knotted that, PLHIV have a lower physical and mental HRQoL score. It has also been knotted that women are mostly affected when compared to the male counterparts (Peninnah, 2013). Literature review From the research that done previously, it has indicated that, HIV-related stigmatization may be connected with mental, psychological and emotional health. The stigma has been associated with despair, stress, loneliness, depression, anxiety, distress, low self-esteem and self-image, emotional health, and mental health. Lower levels of emotions. According to UNAIDS report, there are approximately 33 million people living with HIV/AIDS globally. The stigma that is related to HIV has persisted for over 25 years. The stigma has been the greatest barrier to this pandemic (Peninnah, 2013). There are several stigmas that have been described to be related to HIV/AIDS. Some of the stigmas have been; internalized, symbolic, instrumental perceived, and enacted. Internalized stigma includes having negative beliefs and views towards HIV/AIDS and oneself. Symbolic stigma refers shaming and blaming of groups associated with HID/AIDS by others. Perceived stigma refers to people living with HIV/AIDS (PLHIVs) awareness of reduced opportunity and negative social identity. Enacted stigma includes all the activities of discrimination toward PLHIV. It may include exclusion and violence. Instrumental stigma is whereby measures have been taken to protect oneself and one’s health (Deanna, 2013). Reports from the survey have shown that, the primary cause of morbidity and mortality among African-American women is HIV/AIDS. The reason for the high prevalence is that they are exposed to risks of having partners like men having sex with fellow men and women. Poverty and low living standards also contribute to the prevalence since most of the victims cannot access to Antiretroviral drugs (ARVs). They also lack proper health care, lack of adequate access to early medical attention and drug therapies, and the differential effects of HIV anti-retroviral therapy (Deanna, 2013). Paradigm / Methodology The study used specific questionnaire to collect the required information regarding social, demographic profile, information regarding their sexuality, and clinical data. The clinical data included, time since diagnosis, CD4+ cell count, ARV used, HIV viral load, and the clinical classification of AIDS. The information was used to verify the quality of life. The systemic review was used to develop technical guidelines for HIV prevention and treatment (Deanna, 2013). A qualitative based method was used to extract data and analysis performed in various units that specialized healthcare of PLHIV. The methods used included informal interviews, direct observation, and collective discussion with participants. This process is called ethnographic research methods. It is used to direct the course of the research study. It was based on the assumption through a prolonged interaction with the participants. The researcher was in a good position to understand the individual values, beliefs, actions, and motivations that are expressed through culture (Liamputtong, 2013). The subjects were women living with HIV/AIDS and were over 18 years and frequently use the public health care, and they were able to understand the questions. The subjects were included in a series of criteria whereby, they were scheduled to frequent medical appointments. The patients were evaluated according to the observations and records. The information was also collected from a group setting stigma. The individual interview with the patients was recorded. The engagement of women to air their voices created a platform whereby they were able to tell their stories thus it presented an opportunity to hear their muted voices (Liamputtong, 2013). The group of women that were interviewed was in their 30s and 40s. They confessed to having contracted the disease through heterosexual relationship with their boyfriends, sexual partners, and husbands. Most of these women were mothers and had HIV-negative children, and most of them were jobless; thus, they had unstable income. The aim of the research was to meet women living with HIV/AIDS. An interpretive phenomenology method was used to explore and understand the meanings and goals that women living with HIV are ascribed to and the phenomenon of interest. The meanings and purpose were put into context in their culture, social location, and beliefs. Interpretative phenomenology is whereby themes and concepts are grounded in the data instead of attempting to deduce testable hypothesis from the theories that are existing, or the prior ideas are imposed (Deanna, 2013). Data collection There was a pilot semi-structured interview that was a guide during each interview. Specific questions were included in the perception of physical and mental health, living with genital herpes that are the same as HIV-positive woman. During the meeting, probes were introduced which responded to female narratives, and it explored the depth of women perception and how they relate to HIV symptomatic infections. The goal of the interview was to keep the research open and flexible so that there would be active participants in the study. The interview had to establish a conducive and collaborative hermeneutic conversation which enabled participants to mirror the happenings in their lives and become active agents during the interview (Allyson, 2011). The interviews were recorded in the electronic media and transcribed. The hermeneutic phenomenological reflection that was employed were isolated and highlighted so as to escape the description of the relationship between HIV and symptomatic HSV. A collaborative conversation was incorporated into the research. It was an important component of interpretive phenomenology which was integral. The process involved discussion with the women about their stories during the process of analysis. There was team debriefing that created space for discussing the methodology used to collected data. The debriefing also created the facilitation and development of skills for data analysis. The discussion also developed into the dynamic between the researcher and the responders during the interview and the impact of the data collected and its interpretation (Allyson, 2011). The data was coded, and it was verified by another researcher. The coded data were entered into a computer file in the following format: sample size, age, sex, level of education, ethnicity, disclosure and social support, sexual orientation, physical and mental health. HIV-related stigma was also incorporated into the data (Peninnah, 2013). Data analysis The data that was obtained was proofread to ascertain the trustworthiness of the data and the emerging themes that related to the stigmatization and experiences of the women. Reflexivity was employed to ensure that the voices of the women were heard, and it remained the central point of the study. Collaborative conversation was an important component in the interpretive phenomenology in which it critically analyzed and interpreted the stories of women (Ndidiamaka 2012). The majority of articles that were received had analyzed their data form of correlation coefficients, and there were some that used logistic regression and ratios that were reported were odd. Meta-analysis software was used comprehensively to convert different rates into correlations and also to conduct a meta-analysis on the correlation coefficients. The homogeneity of the correlations was tested using the q statistic. The heterogeneity degree was assessed using the i2 index. The global estimates were obtained through the relationship between the demographic and health factors. They were combined across all the studies and research basing on particular factors and assuming the random effect. The Q statistic and the mean correlation coefficient were calculated using inverse of the variance and weight (Logie, 2008). There were three approaches that were used to uncover the coded data. The methods were 1) sententious approach or holistic approach. It is whereby the transcripts were reviewed, and sentences created to apprehend the essential meaning of the transcript. 2) Highlighting or selective approach that is reading the transcript several times and studying a particular phenomenon. 3) line-by-line method was also used whereby single sentence were analyzed to verify the about the phee4menon of interest (Logie, 2008). Implication for nursing research Nurses are placed in a critical position to educate, intervene, and create new strategies for those who have been infected. Nurses act as health educators who talk to the patient, and family members on the way to promote proper care and treatment. They encourage proper dieting, excesses, and avoidance of substance abuse. They can improve by using disclosure method. It is whereby, the patient disclose their status to people who are close to them. It helps in relieving stress and allowing them to be accepted back to the family (Ndidiamaka 2012). Medical adherence is also encouraged by the nurses. It was observed that some women have been suffering for a long time. It was because they have been subjected to some theme of medication. Thus, they were tired off the drug. They are educated on the importance and seriousness of adhering to medication. There is also an issue of the disease being undetectable thus misleading the patients that they have been healed or cured. The patients may end up stopping to take medication. The nurses, therefore, take the responsibility of encouraging them to continue with medication (Ndidiamaka 2012).
Fulfilling relationships with family and support from friends was encouraged. It is vital to maintaining good mental quality of the patient. They are encouraged to access spiritual support. It was important in strengthening their faith thus giving them hope and motivation regardless of their denomination. The nurses also help them to set and maintain relationships. It helps patients in the maintenance of good mental and physical health. The boundaries of a relationship depended on the social roles they assumed (Peninnah, 2013). The research indicates that, it was more appropriate to detect the infection early so as to start first medications. It was realized that those who took first medication continued living healthy lives. Early medicine enabled them advantageously to take full control of antiretroviral therapies and prophylaxis for opportunistic infections. When the disease is controlled, the morbidity and mortality will be put into total control (Peninnah, 2013). Summary It was discovered that, HIV patients are still stigmatized in the society. They find themselves being placed in extra-societal spaces, being shunned, and they are set aside since they are labeled as having deviant behaviors that lead them to being infected. Such behaviors are prostitution and infidelity. Thus, women living with HIV continue to face stigmatization in the daily lives (Peninnah, 2013). They lose their economic impact sine most of them lose their jobs, and their small scale business do not flourish since they also lose customers. The stigmatization embarrasses them thus they are unable to take medication in the presence of other people. They feel unloved and unsupported even in the presence of close family members. Most women admitted that, lack of support and love from the society makes it difficult to adhere to the medication (Allyson, 2011). It was established that community empowerment interventions were vital to the improvement of the reduction of HIV infection. The increase in the use of condom leads to the reduction in STIs. The empowerment was focused on ensuring safety working condition for patients like labor rights. It also plays a role in rights affirming HIV prevention among the middle and low-class earners. It was also necessary to the strengthening and encouraged financial support for community empowerment (Allyson, 2011). Conclusion From the research, it was realized that there are some factors that may prevent women from accessing social services that are vital. Women living with HIV deserve particular attention because of the incidence that are high and have been identified in the recent years. It is because of the discrimination they suffer in cultural, and gender context that leads to isolation and abandonment. The patient needs to reorganize their lives (Allyson, 2011). Eliciting the voices of women about their experiences with stigma and how they are coping with it, it is expected that awareness will be raised that will amplify the capability of women to withstand the stigmatization. Their ability to resist this stigmatization enables them to live positively. There is the need for continuous evaluation of stigma that is related to HIV. There is also need to help women to get connected with help groups for moral support and access to resources (Ndidiamaka 2012).

Reference

Ndidiamaka N. (2012) African American Women: The Face of HIV/AIDS in Washington. DC Montclair State University, Montclair, NJ USA

Allyson, I., & Harriet, M. (2011) HSV-2/HIV co-infection, health-related quality of life and identity in women. School of Social Work, McMaster University, Hamilton

Peninnah, M., & Rebekah, D. (2013) You Comfort Yourself and Believe in Yourself”: Exploring Lived Experiences of Stigma in HIV-Positive Kenyan Women. University of Wisconsin College of Nursing, Milwaukee, Wisconsin, USA

Logie, C & Gadalla, T. (2008) Meta-analysis of health and demographic correlates of stigma towards people living with HIV. Faculty of Social Work, University of Toronto,Canada

Deanna, L. & Virginia, A. (2013) Community Empowerment Among Female Sex Workers is an Effective HIV Prevention Intervention: A Systematic Review of the Peer-Reviewed Evidence from Low- and Middle-Income Countries. Springer Science and Business Media New York