Tag Archive for HIV

Rewarding research: Social Science and Health Research in Zambia

Rewarding research: Using my ‘self’, psychotherapeutic perspectives and reflection in social science and health research in Zambia

Following a long career in the NHS in Scotland as an Art Psychotherapist and leading several projects training mental health staff in Ghana and Zambia, I embarked on an MSc in Africa and International development at the University of Edinburgh.

My MSc incorporated a work-based placement at ZAMBART[1] in Zambia where I conducted a secondary analysis of case studies of households caring for patients with TB /HIV – from a mental health perspective. This gave me the opportunity to include my ‘self’ and my professional knowledge and stance as elements which worked in dialogue with each other as to inform and shape my dissertation. .

This was no mean task and required both reflection and personal challenge – an acceptance of painful self-realisations – in order to expose the normalised assumptions endemic in my attitudes. I judged men as ‘bad men’ – when their risk taking behaviours impacted on their families. Recognising this and then understanding these behaviours from a non-judgmental psychotherapeutic stance enabled the complex systemic relationships around men’s mental health in rural Zambia to no longer be hidden in a blind spot – beginning their exposure to greater understanding and analysis.

Such fruitful discoveries from such a self-reflective approach and a psychotherapeutic stance point add to the enhanced value of practitioners engaging in research and the blending of psychotherapeutic stances with research objectives.

More detail on this aspect of my work-based placement is given in  Who Cares about Mr Mubanga

 


Lesley Hill, MSc Africa and International Development (2014)

 

References

[1] ZAMBART – a non-for profit research organisation based within the University of Zambia that is also a research collaborating centre for the London School of Hygiene and Tropical Medicine

 

Reflections from the HIV, Human Rights and Development (HHRD) Network on World AIDS Day, December 1, 2014

The Joint United Nations Programme on HIV/AIDS (UNAIDS) (2014) Report “Fast-Track: Ending the AIDS epidemic by 2030” provides more than a beacon of hope on World AIDS Day 2014.

It states boldly that “The world is embarking on a Fast-Track strategy to end the AIDS epidemic by 2030”.

It envisages that if the world scales up its HIV prevention and treatment programmes and reaches certain fast-track targets or goals, it will manage to prevent almost 28 million new infections and more crucially “end the AIDS epidemic as a global health threat by 2030”.

The report points to a number of “fast-track targets” that need to be achieved in the next five years by 2020. These optimistic targets include: attaining a 90-90-90 target, i.e. 90 percent of people with HIV knowing their status, 90 percent of those who know their status being on treatment, and then 90 percent of those on treatment suppressing the virus. For the year 2030, this goal goes up to 95-95-95. New infections will be reduced by 75 percent to 500,000 by the year 2020, and then to 200,000 by 2030. And, it points to the overarching goal of zero discrimination and zero tolerance for both years—2020 and 2030.

However, to achieve this monumental, yet attainable goal, the report cautions that “countries will need to use the powerful tools available, hold one another accountable for results and make sure that no one is left behind”.

We at the HHRD Network believe that the commitment to human rights will provide the bedrock of the AIDS response, and that human rights will need to remain in the fore front of all efforts. Moreover, that there is a need for a sustained and continued investment to build and promote the capacity of health systems all over the world, but particularly in the context of developing countries and forced migration. We need to consider on how best we can attain the theme of World AIDS Day 2014 to “Focus, Partner, Achieve: An AIDS-free generation – to highlight the need to for governments and health officials, NGOs and individuals to address AIDS prevention and treatment”. And, finally, the “fast-track targets” need to be held closely by all players across the globe if we are to not just bend the epidemic trajectory, but to break it irreversibly”.


 

Dr George Palattiyil and Dr Dina Sidhva

Joint Convenors, HIV, Human Rights and Development Network

HIV/AIDS: into the third decade

1981 saw the first description of AIDS cases in the USA. There are now over 100,000 people living with HIV in the UK and around 34 million people worldwide. In 2011, an estimated 1.7 million people worldwide died from HIV related causes. In the UK, around 1 in 5 patients living with HIV are not aware of their diagnosis; more efforts should be done to identify them so that they can benefit from antiretroviral treatment and improved health. Treated early, patients with HIV can look forward to an almost normal life span.

Despite extensive research, there is no effective vaccine for treatment or prevention of HIV infection. Treatment is effective and is required lifelong as at present there is no cure.  Antiretroviral therapy fails to cure HIV infection because latent proviruses persist in resting CD4+ T cells.

Although the international response to HIV epidemic has not been rapid, more than half of people eligible for ART in low and middle income countries were receiving ART for the first time in 2011.

Lifelong therapy means that patients are exposed to potential drug toxicity for a prolonged period. People with HIV are living longer; the proportion of patients aged 50 and older are an increasing proportion of the population of persons living with HIV in the UK. Older people with HIV/AIDS face both HIV/AIDS-related and age-related co-morbidities, such as hypertension, chronic pain, hepatitis, and arthritis, which are associated with poorer physical, mental, and social wellbeing.

The global HIV epidemic is one of the most formidable challenges to life and human dignity; it undermines social and economic development worldwide. Efforts at eradicating HIV must be maintained by finding a cure for those who are already infected and an affordable and effective vaccine to prevent new infections.

 

Professor Clifford Leen

Consultant Physician Infectious Diseases (Western General Hospital) Professor Infectious Diseases (Edinburgh University)

 

CLS Leen (6x4)