Nhận thức của người nhiễm HIV về lối sống của họ _ Perception of People Living with HIVAIDS on Their Lifestyle in Mandalay

Nhận thức của người nhiễm HIV về lối sống của họ _ Perception of People Living with HIVAIDS on Their Lifestyle in MandalayIntroductionHIVAIDS is the greatest health crisis faced by the world.IN Myanmar,HIVAIDS is one of the priority diseases in National Health Plan.National Health Committee has provided clear guidelines to fight AIDS as a disease of national concern.In Myanmar, HIVAIDS prevention and care activities had been implemented since 1989.For the prevention and control measures, the perception and practice of PLWHA on their lifestyle is important.Correct perception and practice of PLWHA can considerably improve his or her quality of life.Therefore to probe more depth to perception and practice of PLWHA, qualitative approach of study must be applied.ObjectivesGeneral ObjectiveTo explore the perception of PLWHA on their lifestyles.Specific ObjectivesTo assess the perception and practice of PLWHA on the prevention of HIV infection to other person.To find out the expectations of people living with HIVAIDS for their livesResearch MethodologyStudy designCross sectional descriptive study was conducted by applying qualitative approach.Study areaMandalay division, MyanmarStudy populationPLWHA from Mandalay who are attending ART clinics including:AIDSSTD clinic (NAP)Integrated Health Care (IHC) program (NGO, AZG)Inclusion criteria PLWHA who are between reproductive age group (1549 years)Exclusion criteria Those who are mentally retarded.

Public Health Specialist Health and Diseases Control Unit Ministry of Defense, Myanmar

HIV/AIDS is the greatest health crisis faced by the world.

IN Myanmar,

HIV/AIDS is one of the priority diseases in National Health Plan.

National Health Committee has provided clear guidelines to fight AIDS as a disease of national concern.

In Myanmar,

HIV/AIDS prevention and care activities had been implemented since 1989

For the prevention and control measures, the perception and practice

of PLWHA on their lifestyle is important.

Correct perception and practice of PLWHA can considerably improve his or her quality of life.

Therefore to probe more depth to perception and practice of PLWHA, qualitative approach of study must be applied.

PLWHA from Mandalay who are attending ART clinics including:

AIDS/STD clinic (NAP) Integrated Health Care (IHC) program (NGO, AZG) Inclusion criteria

PLWHA who are between reproductive age group (15-49 years)

Exclusion criteria

Those who are mentally retarded.

Research Methodology

Study period

From July 2013 – October 2013

Sample size determination

As there is no hard and fast rules for (non-probabilistic) sample size in qualitative research, determination of sample size based on purpose of the study and available time and research

Research Methodology

Sampling method

Purposive sampling was applying

Who are willing to participate in the study

Data collection method and Materials

First of all, appointment was made with PLWHA who are attending ART clinics

Then in-depth interviews were carried out in a separate room in order to ensure the privacy

There were about 3 PLWHA interviewed per day and time consuming is about 45 minutes per PLWHA

Research Methodology

Data processing and Analysis

All interviews are noted and recorded in detail.

Moreover gesture and tone of voice of interview were also noted

Notes and records of the interviews were transcribed after the data collection.

Coding was done by using ALTAS.ti software.

Themes and sub themes were identified carefully and matrix analysis was done manually to fulfill the objectives of the study.

Ethical consideration

Written informed consent was obtained after explaining the purpose of the study.

Participants were also explained and ensured for the anonymity and confidentially.

Researcher tried to get rapport with PLWHA by taking time to contact and make believe of PLWHA using frequent visiting to their centers.

No Background Characteristics Frequency

1 Age (in years)

No Background Characteristics Frequency

Knowledge and Perception about HIV/AIDS

All respondents have heard about HIV/AIDS before they had been diagnosed as HIV positive.

Only a few knew comprehensively about HIV/AIDS before diagnosis.

]] … I have heard a little bit … I did not know exactly about HIV… I know only AIDS…

mostly transmitted through sex and drug use… }}

(35)Years old, male, single)

Way of Getting Diagnosis

Majority (14 out of 20) of the respondents tried to seek health care as they had suffered from opportunistic infections and the medical persons advised them to have HIV test

Among them, those who sought health care with general practitioners did not get pre and post test counseling

Some had been suggested by their friends to get the blood test by looking their appearance at that time

- Decided to test by themselves

Only one respondent

- Went to NAP

Laboratories without counselling services

Laboratories with counselling services

Way of Getting Diagnosis

Prevention of HIV Transmission to other

person

All respondents were aware of mode of transmission of HIV after they have diagnosed as having HIV.

As a normal daily family life.

Trying to practice safety precautions.

]] … I know that HIV can not be transmitted from daily family living It can be transmitted

from blood and sexual relationship So I can stay as normal I use condom if I stay with my

wife… ʼʼ

(41Years old, female, married, private employee)

Perception and Practice on Involvement of

PLWHA in Activities to Prevent, Control and Care

for HIV/AIDS

All respondents -wish to involve.

Most respondents

changed their lifestyles

Joined NGOs and INGOs

Currently, 13 out of 20 are being appointed as volunteers from NAP.

Tried to help and guide other PLWHA in order to get proper counseling and treatment

]] … I involved in the activities like home-based care, counseling and gathering, and then

I always give help and kindness to any other PLWHA because I become aware of the

difficulties for PLWHA Therefore, I’m willing to do for all… ʼʼ

(35Years old, male, married, government employee)

Expectations for Their life

All respondents knew that quality of life of PLWHA could be improved by modifying their lifestyle.

All …hoped for the medicines that can cure HIV

Regarding their life, they wish to live until their children are grown up and graduated

]] … We hope for the sustainability of self help groups Others could not understand our feeling We could only understand ourselves Psychological support can also get from each other… ʼʼ

(35Years old, male, married, government employee)

]] … As for me, I would like to spend the time well in the future I would like to live, eat

and drink similar to others I would like to see my son living with good health and long life Because my son is a bay, I would like to see as a monk And then, I have nothing special… ʼʼ

(29Years old, female, widow, dependent)

Knowledge about HIV/AIDS,

Most of them did not have comprehensive knowledge before they got infection

It meant that they became knowledgeable about the disease after getting infection

In a Behavioral Surveillance Survey (2007) in Myanmar,

Although 98% of the respondents have heard of HIV, comprehensive and effective knowledge about prevention methods was low

Diagnosis and treatment seeking behaviors,

Almost all respondents did not receive both pre-test and post-test counseling Quite alarming to know that not received proper counseling.

Another published paper from Myanmar,

All of PLWHA took self medication for infections.

Half of them have consulted private physicians for prevention of diseases.

(Soe-Htun, 2003)

Perception and Practice on Involvement of PLWHA in Activities to Prevent,

Control and Care for HIV/AIDS,

Awareness and practice in positive prevention behavior could be seen in

most respondents

And then, changed their lifestyle and actively participated in prevention and control activities

However, extent of participation was different among male and female

Another published paper,

PLWHA need to be supported through skills development, counselling and incentives to carry out sensitization and personal testimonies

(Nvule, RS., 2004)

Many respondents, before they have been diagnosed as HIV status, did not know exact information

Majority did not expect the positive result

Most respondents knew it can not be transmitted by living as a normal daily family life

Most responds changed their lifestyles

Male respondents could involve in these activities more than female respondents

The awareness and perception about HIV/AIDS in the community that can lead

to behavioural change and adoption of healthy lifestyle should be promoted using peer education approaches

Effective counseling services and care including PMCT, OI and ART services should be provided for those in need with emphasis on PLWHA and their family members

Aye-Myat-San, Aye-Aye-Sein and Khin-Ohnmar-San, 2009 Behavioural Surveillance

Survey 2007, General Population NAP, Department of Health, Ministry of Health

Nay Pyi Taw Myanmar

Babalola, S, Kornfield, R., 2004 HIV prevention, care and support – an infotainment approach by PLWHA International Conference on AIDS John Hopkins University, Baltimore, the United States of America

Bharat, C., et al., 2005 The Clean Cohort: Impact of an expanded access programme to HART in survival and risk factors Program and abstract of the 3rdIAS Conference on HIV prevention

Hmone, MP., 2003 Level of awareness related to sexually transmitted infections among pregnant women attending antenatal clinic at Central Women Hospital, University of Medicine (1) M.Med.Sc (Public Health) thesis, 2003

Htike-Myat-Phyu, 2006 Gender differences on HIV?AIDS related Knowledge, Attitude and behaviors of attendees at Central Sexually Transmitted Diseases, University of Medicine (1) M.Med.Sc (Public Health)

Kyu-Kyu-Than, et al., 2007 Reproductive health needs HIV positive

women: client perspective The Myanmar Health Sciences Research

Journal, Vol.19, No.3, 2007.

Mandalay Division AIDS-STD prevention and control, 2005 Themes for

World AIDS Day, annex 10 Department of Health, Ministry of Health Nay

Pyi Taw Myanmar.

Myo-Myo-Mon, Saw-Saw, Yin-Thet-Nu-Oo, San-Hmone and Kyaw-Oo,

2009 Socio-economic and health consquences among HIV/AIDS orphans

in Yangon Unpublished report.

Nvule, RS., Ruharo, B., and Countinho, AG., 2004 International

Conference on AIDS, 15th : 2004 : Bankok, Thailand The AIDS Support Organization, Kampular, Uganda.

Soe-Htun, 2003 Effectiveness of education of high risk group in Yangon

on HIV/AIDS using socil network approach University of Medicine (1) Yangon M.Med.c (Public Health) thesis 2003.

Thank you