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    Male attitudes and behavioural change in Tanzania, in relation to HIV and AIDS : a thesis submitted in partial fulfilment of the requirements for the degree of Master of Philosophy in Development Studies at Massey University, Palmerston North, New Zealand
    (Massey University, 2012) Lloyd-Jones, Timothy John
    Although there has been some encouraging progress towards combating the Human Immunodeficiency Virus (HIV) and the resulting Auto Immune Deficiency Syndrome (AIDS) in recent years, AIDS continues to cause premature death and hardship for many families. Sub-Saharan Africa accounts for 68 percent of the worldwide HIV infections, an estimated 22.5 million people (UNAIDS 2010:2). This thesis examines the relationship between men’s attitudes and behaviour in relation to HIV and AIDS. It is important to focus on men in the battle against HIV because men often control women’s sexual and reproductive health. Grieg (2005:1) and other commentators believe the socialization of boys and young men to be a major factor in the spread of HIV/AIDS. The ways in which boys and young men are socialised are strongly influenced by prevailing cultural norms. Fieldwork was carried out in the Iringa region of the United Republic of Tanzania during June 2008. Interviews and focus group discussions were conducted with men of different ages and socio-economic backgrounds. Results showed that culture and influential role models strongly influence men’s attitudes and behaviour in relation to HIV and AIDS. This thesis confirms other research for example Silberschmidt (2001), who argued that sub-Saharan Africa is undergoing an identity crisis as changes in society have eroded men’s traditional role as hunter and provider. Many men are facing feelings of inadequacy, inferiority, lack of self-esteem and depression. Faced with these feelings of disempowerment, many men often resort to alcohol and extra-marital relationships, which increase the prevalence of HIV. One of the challenges facing those involved in reducing the spread of HIV is to help men face up to these feelings of inadequacy and develop a healthy lifestyle, despite changing social and economic conditions in 21st century sub-Saharan Africa.
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    From experiencing social disgust to passing as normal : self-care processes among Thai people suffering from AIDS : a thesis presented in fulfillment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Palmerston North, New Zealand
    (Massey University, 2008) Siriwatanamethanon, Jirapa
    AIDS is a chronic disease that seriously affects health, emotions, social relations and household economy. People living with HIV/AIDS experience great suffering, stigmatisation and discrimination from other people around them because they know that it is incurable, contagious, evokes social disgust and is a complex disease requiring life-long self-care. This researcher explored ways people with HIV/AIDS take care of their health and manage their lives in the context of stigma and discrimination. A grounded theory study was conducted with 30 participants with HIV/AIDS, in Mahasarakham Province, Thailand. Participants were recruited from an HIV/AIDS day care clinic and by snowball sampling. Data were gathered through in-depth interviews, participant observations and field notes made during home visits. Interviews were tape recorded, then transcribed verbatim. “From experiencing social disgust to passing as normal” was generated inductively from the data as the basic social psychological process of Thai people living with HIV/AIDS. From experiencing social disgust to passing as normal comprised four categories: being HIV/AIDS, making choices, keeping well and feeling empowered. The category “being HIV/AIDS”- discovering the meaning of having HIV/AIDS, comprises four concepts: being diagnosed with HIV/AIDS, being stigmatised, suffering, and learning about HIV/AIDS. The category “making choices”- to live a normal life, involves three concepts: avoiding unhappy situations, getting remarried and seeking support. The category “keeping well”- maintaining emotional and physical health, includes eight concepts: religious practices, keeping a cheerful mind, self-treatment, taking care of the body, keeping the environment clean to prevent getting germs, healthy behaviours, getting healthcare services, and attention to, and concern about, medication. The last category “feeling empowered”- personal and social acceptance of illness, includes eight concepts: being encouraged, acknowledging the disease, social acceptance, tamjai, feeling proud of self, feeling good about life, feeling lucky and having hope. In the context of northeastern Thailand, successful management of HIV/AIDS was underpinned by participants making a transition from “experiencing social disgust” to “passing as normal” within their communities. The desire to live a normal life despite having HIV/AIDS motivated participants to undertake effective self-care in order to remain symptom free (thus avoiding visible signs of the disease), and to selectively disclose their illness to avoid the ongoing risk of stigma and discrimination. The findings of this study are useful in that they will provide Thai health professionals with a clearer conceptualisation of self-care among the Thai population. An inductively derived theory of self-care among Thai with HIV/AIDS can be applied and integrated by health professionals into the self-care models for people living with HIV/AIDS including models used in nursing education, research and practice.