Alice S. Demi

Spiritual activities as a resistance resource for women with human immunodeficiency virus.

BACKGROUND Few studies have investigated the role that spiritual activities play in the adaptational outcomes of women with human immunodeficiency virus (HIV) disease. OBJECTIVE To examine the role of spiritual activities as a resource that may reduce the negative effects of disease-related stressors on the adaptational outcomes in HIV-infected women. METHODS A theoretically based causal model was tested to examine the role of spiritual activities as a moderator of the impact of HIV-related stressors (functional impairment, work impairment, and HIV-related symptoms) on two stress-related adaptational outcomes (emotional distress and quality of life), using a clinic-based sample of 184 HIV-positive women. RESULTS Findings indicated that as spiritual activities increased, emotional distress decreased even when adjustments were made for HIV-related stressors. A positive relationship between spiritual activities and quality of life was found, which approached significance. Findings showed that HIV-related stressors have a significant negative effect on both emotional distress and quality of life. CONCLUSIONS The findings support the hypothesis that spiritual activities are an important psychological resource accounting for individual variability in adjustment to the stressors associated with HIV disease.

Rescue workers' reactions following the hyatt hotel disaster

Abstract The collapse of the skywalks at the Hyatt-Regency Hotel in Kansas City was one of the most traumatic man-made disasters in this countrys history. The workers and volunteers who participated in the rescue activities were exposed to numerous stressors that made them at risk for physical and emotional sequelae. The purpose of this study was to describe the physical and emotional reactions and the help-seeking behaviors of these rescue workers. Findings support the need for more primary prevention services for rescure workers.

Self-Disclosure of HPV Infection to Sexual Partners

Disclosure decisions of persons with genital HPV infection were examined. The research questions focused on relationships among knowledge of transmission, beliefs about the obligation to disclose knowledge of HPV infection to sexual partners, factors that influence the disclosure decision, and evaluations of the decision. Participants were 92 persons diagnosed with HPV 6 months prior to data collection. Sixty-three women and 29 men whose average age was 23.1 years constituted the sample. A subset of 48 persons provided detailed information about their reasons for disclosing or not disclosing knowledge of HPV and subsequent evaluation of their behavior. Knowledge of HPV transmission was adequate; however, there was no relationship between transmission knowledge and disclosure beliefs. Participants tended to disclose the presence of HPV to partners at point of diagnosis, but not to new partners 6 months later. Both disclosers and nondisclosers felt positively about their decision. Possible changes in clinical interventions for persons with HPV infection are discussed.

Commentary by Demi

On reading this article, I was struck by the universality of stigma related to HIV and AIDS. The literature is replete with both quantitative and qualitative studies reporting on the occurrence of stigma and the negative impact of stigma on both informal caregivers and on patients with HIV and AIDS. Stigma related to HIV and AIDS is reported in Zimbabwe, Ghana, India, Thailand, Japan, the United States, and many other countries. Stigma crosses cultural and geographic boundaries. The authors of this qualitative study sought to examine the experiences of informal caregivers of AIDS patients in a city in Ghana. They identified four themes: care under cover, loneliness and isolation, lack of support, and disrespect from health workers. These are common themes in the literature across countries. The difference is the social and economic context within which the illness occurs and the care is given. Within the context of poverty in many undeveloped countries, stigma is especially pronounced. This stigma prevents patients and caregivers from accessing health care services and shuts them off from family members and friends. Although stigma still occurs in developed countries, education about the cause of the disease and how to prevent infection, coupled with the availability of treatments, has reduced stigma. In the United States, many health care workers choose to work in AIDS treatment facilities where they provide quality care and empathy to patients and their family caregivers, which is in marked contrast to the care described in this study. Of course, in the United States, there are still pockets of ignorance and misinformation and beliefs that AIDS is a punishment from God for certain types of sexual behavior or illicit drug use. Another commonality across countries and cultures is the heavy burden that caregiving has on women. The women in this study had the dual burden of being caregivers to an HIV–infected family member and being caregivers to numerous other dependent family members while often having to be the economic support for the family. This was particularly pronounced in Ghana because of the large number of dependent children affected by the HIV status of a parent.